Outpatient Forms for Great Lakes Center for Autism Treatment and Research

For your convenience, below you can find forms related to the services we have available at the Great Lakes Center for Autism Treatment and Research.

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(30 documents)

Intake Packet

Table of Contents- Parent Handbook

Welcome Letter

A link to GLC Mission-Vision-Core Values

GLC Mission-Vision-Core Values

Location and Hours of Operation

School Year Calendar 2021-2022

What is ABA?

Types of Services Available at GLC

Arrival and Departure

Session Cancellations and No-Show Appointments

Severe Weather Procedures

For All Sessions at the Center

Client Sick Procedures

Medication Administration Procedures

ROI Use of Sun Protection

Patient Rights and Responsibilities

Recipient Rights Notification Form

Confidential Medical Information

Consent for Treatment Form

HIPAA (what you should know about the protection of your privacy)

Authorization for Release of Information

Authorization for Release of Information - Natural Environment

Authorization for Drop Off and Pickup and Permission to Observe

Release of Photographs, Audio, and Video Imagery

Financial Policy

Restraint and Seclusion Policies and Procedures

Permission to Transport

Family Notification Form (Email Request)

Permission for Electronic Transmission (Internet and Text) of Information

A link to GLC Financial Assistance Application

GLC Financial Assistance Application