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ADOS-2 ASSESSMENT FORM

The ADOS-2 is an observational assessment used in part to assist in the diagnosis of Autism. Please fill out the following information to help schedule your ADOS assessment.

PARENT INFORMATION*
PHYSICIAN INFORMATION*

A referral from your child's physician is necessary and results will be faxed directly to your child's physician.

CLIENT INFORMATION*
The assessment will be delivered in English, will your child be able to participate?
CAREGIVERS MAIN CONCERNS

Thanks for submitting! We will be in touch soon!

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