Documents and Forms

If you are interested in intensive ABA treatment for your child, please complete and return this form. You can e-mail this form to vmoyer@cornerstoneautismcenter.com, fax it to 317-888-1571 or mail the completed items to 380 Polk Street, Greenwood, IN 46143.

This form should be completed by your child’s physician as a referral for ABA therapy.

We are able to bill many insurance carriers for our services. Please complete and return this registration form with your current insurance information.

Cornerstone is committed to protecting your privacy. This Statement of Privacy applies to Cornerstone Autism Center site; as well as governing health information, data collection and usage. By using the Cornerstone Autism website, you consent to the data practices described in this statement.

Fevers, coughs and sniffles…oh my! As a reminder, please familiarize yourself with Cornerstone’s sick policy.

A list of financial resources and grants available for families of children with autism.

A person-specific informational form for first responders during emergency situations.

Key state and national organizations that provide free webinars to families.

Submit this form to authorize staff members at Cornerstone Autism Center to administer medication to your child.

Submit this form to give advance notice of your child’s absence from therapy.