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Required Intake Information

1

Intake Packet

Please follow the link below to complete LaHaye and Doll ABA Services Intake Packet. We ask that you fill out the packet as honestly and completely as possible in order for our practitioners to assist with services.

2

Signature Pages

Follow the link below to access our Client Handbook & HIPAA Confidentiality Agreement. It is recommended that you print and save copies of these documents for your records. Once all signatures have been collected, our Intake Coordinator will get in contact with you.

You must complete BOTH the Intake Packet & Signature Pages to be placed on the waitlist for services.

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130 S. Buchanan St.

Lafayette, LA 70501

Phone: 337-769-3413

Fax: 337-769-3414

office@ldaba.com

Office Hours

Monday - Friday

8:30 AM - 3:00 PM

Connect with us on Social Media!

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© 2020 by LaHaye and Doll ABA Services

All rights reserved.

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