Open Enrollment is from Nov 1st, 2024 – Jan 15th, 2024
Enroll Now

Referrals

Welcome to Rise Up for Autism’s patient referrals page. We are dedicated to providing high quality and compassionate Applied Behavior Analysis (ABA) therapy to the patients and families you serve. At Rise Up, we provide full day and half day center-based therapy to children ages 2-6 on the autism spectrum. We focus on increasing communication, social, and independent living skills while reducing challenging behavior. In addition, we have a school readiness program to better prepare our young children for the next step in the academic journey.

Woman and young girl drawing at a table with colored pencils.

Rise Up for Autism - Patient Referral Form

Please fill out our easy-to-use referral form and a member of our outreach team will be in touch with the family within 1 business day.

  • Please complete this required field.
  • Please complete this required field.
  • Email must be formatted correctly.
  • Please complete this required field.
  • Incorrect number format
  • Please complete this required field.
Child’s Insurance *
    • Please complete this required field.
    • Email must be formatted correctly.
    • Please complete this required field.
    Thank you! Your submission has been received!
    Oops! Something went wrong while submitting the form.