Individuals who would like to receive services at the UW Autism Center need to complete the online registration form here:
Alternatively you can download print the registration form from here to fill out and return via mail or fax. This must be returned to the UW Autism Center prior to scheduling your first appointment, or, if services are not immediately available, to be placed on the waiting list. A referral from your primary care provider (PCP) does not automatically place you on the waiting list.
We will contact you to schedule as soon as appointment(s) are available. Once the appointment is scheduled, please click on the forms below, print, and complete. We are also happy to send you these forms in the mail:
- Diagnostic evaluation: Adult or Child & Adolescent (3-18)
- Infant/Toddler intake form (0-36 months)
- Speech/Language services
- Applied Behavioral Analysis (ABA)
- a Privacy Notice and Acknowledgement Form,
- and a Fee Schedule.
Please return the adult or child & adolescent intake form as soon as possible so your provider can review it before your visit. You can mail or fax this form to us.
Prior to your first appointment, our Patient Navigator will contact you to discuss the fee schedule, pre-authorize your evaluation with your insurance company, and then advise you of what the costs will be.
We encourage you to contact your insurance company directly to check your coverage of services. See insurance page for more information.
For community providers who would like to refer clients to the UW Autism Center, please note that all clients must complete the registration form. Referrals from primary care providers do not automatically place clients on our waiting list. If a client’s insurance carrier requires a referral from their PCP, please send the referral to the insurance carrier and fax a copy to our Seattle clinic at (877) 719-8701 or our Tacoma clinic at (253) 692-4718.
For more information about our services or the intake process you may call our intake coordinator at our Seattle clinic at (206) 616-8642 or our Tacoma clinic at (253) 692-4711, or email us at firstname.lastname@example.org.