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Milestones Autism Resources

4853 Galaxy Parkway, Suite A
Warrensville Heights, OH 44128

Phone: (216) 464-7600

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Intake Form for Professional on Behalf of Client

This form is to be completed by a professional who is looking for assistance on behalf of a client.

Si el español es su idioma principal, puede traducir este formulario (y este sitio web) al español haciendo clic en la palabra Español en la esquina superior derecha de la ventana de este sitio web.

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Need assistance? Let Milestones be your local guide.

Unsure of where to start? Contact our free Helpdesk with your questions, and we will do the research for you!

Visit milestones.org/helpdesk and complete an intake form.