Center for Promoting Research to PracticeAboutMission and vision Faculty and staff ResearchATTAIN Bayesian Analysis of Academic Outcomes from Single Case Experimental Designs Catch and Release Links to Learning: Adaptive Math Assessment (LLAMA) Parents Plus Project PEAK Lehigh Reach Lab Project RISE Project STAYMeet the Team Year 1 Activities (2021-2022) Year 2 Activities (2022-2023) Year 3 Activities (2023-2024) Year 4 Activities (2024-2025) Project STAY Presentations Frequently Asked Questions Contact Information Sponsored Research Agreement with Renaissance Learning Supported College and Career Readiness Resources for Teachers Resources for Parents Resources for Mental Health Providers Lehigh University Autism Services Initial Screening Form Date * MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year20222023202420252026 Year Name of Parent/Legal Guardian 1: * Name of Parent/Legal Guardian 2: Child Name: * Age: * Diagnosis (by whom and when): * Home Phone Number (no dashes): * Email: * Mailing Information (you need to be within 30 miles of Lehigh) Street address: * City * State: * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip code: * What are the behaviors of concern? * Are you (or your spouse) an employee at Lehigh University? * Yes No Insurance Do you have private Insurance? If so, what type? * Do you have Medical Assistance? * Yes No Do you plan to pay out-of-pocket? * Yes No How did you hear about us? * Leave this field blank Submit
Date * MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year20222023202420252026 Year Name of Parent/Legal Guardian 1: * Name of Parent/Legal Guardian 2: Child Name: * Age: * Diagnosis (by whom and when): * Home Phone Number (no dashes): * Email: * Mailing Information (you need to be within 30 miles of Lehigh) Street address: * City * State: * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip code: * What are the behaviors of concern? * Are you (or your spouse) an employee at Lehigh University? * Yes No Insurance Do you have private Insurance? If so, what type? * Do you have Medical Assistance? * Yes No Do you plan to pay out-of-pocket? * Yes No How did you hear about us? * Leave this field blank Submit