Functional Behavior Assessments Form

Child's Name

First Name

Last Name

Birthdate

YYYY

Parent Name

First Name

Last Name

Parent Email

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

School Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

My child has been diagnosed with the following:

Please check all that apply.

Autism

ADHD

OCD

Anxiety

Depression

Other:

Are you working with an education attorney?

What are your main concerns regarding your child's behavior?

What do you hope to gain from a Functional Behavior Assessment for your child?

Our BCBAs are highly skilled at conducting Functional Behavior Assessments (FBAs) across school, home and community settings to determine the function and presence of any interfering/challenging behaviors. We have extensive experience working with education attorneys and providing in-depth, detailed FBAs, about which we are able to confidently testify in judicial hearings. We also provide private FBAs for families who desire professional help in determining the function of their child’s behaviors.

Upon completion of most FBAs, our team creates individual Behavior Intervention Plans (BIPs) to be followed in home, school and/or community settings, depending on the nature of the challenging behavior and the individual needs of the child. These plans provide proactive and reactive strategies for behavior management. FBAs and BIPs are written by our highly trained Board Certified Behavior Analysts (BCBAs) and Licensed Behavior Analysts (LBAs).