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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

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(269) 250-8200

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