Refer a Patient
to Ally Behavior

A form designed for providers

Provider Referral Form
Provider Hero

This page is specifically designed for providers seeking to refer a patient of theirs for either a diagnostic evaluation or ABA therapy services with Ally Behavior. If you are a parent independently seeking to connect with us, we invite you to click here to complete our Contact Form.

Referring to Ally Behavior is Easy

Explore the referral options below to choose the method that’s best for you.

Form

Online Referral Form

Complete our one-minute Provider Referral form, and our team will reach out to your patient's family within 24 hours.

60 seconds to refer today!

Provider Referral Form
EMR

EMR System

Add Ally Behavior Centers to your EMR system for quick referrals.

People Images Master (19)

Send Parents the Link

Direct the family of your patient to reach out to Ally directly via this link.

FAX

Fax Referral

If your office prefers to fax referrals - no problem! Send your standard referral documentation by fax to (833) 220-8662.

Prefer to use Ally's Fax form?

Ally's Fax Form

Provider Referral Form

Providers, please use the following form to submit your referral or you can fax your standard referral documentation to (833) 220-8662.
Our team contacts families within one business day. We make the process easy by handling benefits checks and scheduling internally.

Who to Refer...

  • Children between the ages of 18 months to 4.5 years old
  • Children without a diagnosis of autism who are in need of a formal diagnostic evaluation
  • Children with a diagnosis of autism who would benefit from a combination of full-time ABA, Speech, and Occupational Therapy

Our Services...

Ally Behavior is a full-time, center based program for early learners with ASD. Children enrolled in our ABA Therapy program benefit from a person-centered approach, with Speech and Occupational Therapy services integrated into their program as needed.

Do you have a family waiting for an autism diagnostic evaluation?

Ally Behavior Centers has on-staff developmental pediatricians and clinical psychologists who can provide in-person, comprehensive diagnostic evaluations. Our waitlist is between 45 to 90 days.

If you are a provider and have questions about referrals, or wish to learn more about Ally Behavior, please direct your questions to:
Rebecca Couture, Director of Community Outreach (rcouture@allybehavior.com)

LEARN ABOUT
ALLY BEHAVIOR

At Ally Behavior Centers, we recognize that parents and guardians are a child’s strongest advocates, but their healthcare team plays a vital role in that support system.

Medical providers are often among the first to notice potential signs of autism. By referring a patient to Ally Behavior Centers when concerns arise, you help families get answers quickly - positioning the child to receive support during a critical window for development.

After discussing with the child’s family, please complete our Provider Referral Form. Our team will contact the family within one business day to begin the diagnostic or enrollment process.

We offer a guided enrollment experience, supporting families at every step - from insurance benefits checks to center tours - so they feel informed, supported, and cared for throughout.

Image showing the Person Centered Therapy Model enhancing ABA therapy services at Ally Behavior.

The Ally Behavior Difference

At Ally Behavior Centers, we bring all the essential services together under one roof in a person-centered therapy model. In addition to high-quality ABA therapy, every center offers on-site speech and occupational therapy. Our comprehensive program supports not just developmental goals, but also everyday life skills like toilet learning and classroom readiness.

We believe true progress happens when children can apply what they learn beyond our walls. That’s why we offer parent training sessions to empower caregivers with the tools and confidence to support their child at home, in the community, and wherever life takes them.

ABA THERAPY
AND COVERAGE

We understand the importance of insurance coverage when it comes to making the right referral for your patients. Ally Behavior Centers accepts most commercial plans, and one of the first steps in our enrollment process is a full benefit check for our interest families. Families are given an easy-to-understand report of their coverage, with transparency about any associated out of pocket costs. For added assurance, our team of specialists handles all “pre-authorization” paperwork directly with their insurance company to make certain that their child’s therapy is covered before services begin.

Logos of insurance providers accepted by Ally Behavior Centers for ABA therapy, autism testing, speech therapy, and occupational therapy.
Aetna logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.
Kaiser Permanente logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.
Tricare logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.
Cigna logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.
CareFirst logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.
Anthem logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.
Johns Hopkins Family Health Plan logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.
Johns Hopkins EHP logo showing Ally Behavior Centers is an in-network provider for ABA therapy and autism services.

Ally Behavior Centers accepts most major insurance plans, including Aetna, Blue Cross Blue Shield, Cigna, Tricare, and UnitedHealthcare, ensuring families in Maryland, Virginia, and Texas can access high-quality ABA therapy and autism services with coverage.