Contact Us

At Inspire Horizons, we’re dedicated to supporting your child’s growth through compassionate, individualized care. Fill out the form below to be contacted about how we can support your child today!

Client Inquiry Form

"*" indicates required fields

About Your Child

What is your child's first name?*

What is your child's last name?*

What is your child's date of birth?*

Our team specializes in ABA therapy for children up to the age of 10.

Which location are you interested in?*

If 'other' indicate your preferred location.

Please indicate why you are interested in seeking ABA services for your child (check all that apply):*

Received a referral for ABA

Have concerns regarding their skills and abilities

Have concerns regarding challenging behavior

Other

Has your child been diagnosed with Autism Spectrum Disorder within the past 3 years?*

Do you have a physical copy of the diagnostic report that reflects this diagnosis being given to them?*

Please select the services your child is currently receiving:*

ABA Therapy

Speech Therapy

Occupational Therapy

Physical Therapy

Other

Is your child currently in school?*

Who is your child's primary insurance provider?*

If you selected "other", who is your child's primary insurance provider?

How Can We Reach You?

We would love to chat with you. How can we get in touch?

What is your first name?*

What is your last name?*

Your email address*

Your phone #*

Zip Code*

When would you like to start in our ABA therapy program?*

How did you hear about us?*

Are you willing and able to commit to utilizing 90% or more of the medically appropriate level of care, as determined by your child's Behavior Analyst?*

Are you willing and able tio commit to attend and consistently arrive on time to your child's scheduled service appointments? We require a minimum 95% attendance rate.*

Name

This field is for validation purposes and should be left unchanged.

Contact Us

At Inspire Horizons, we’re dedicated to supporting your child’s growth through compassionate, individualized care. Fill out the form below to be contacted about how we can support your child today!

Client Inquiry Form

About Your Child

How Can We Reach You?

Open ABA Enrollment at Tucson & Phoenix Locations

No Wait List