Inquiry Form
First Name
Last Name
Email
Phone
I am interested in:
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Adult Services
Autism Diagnostic Resources
Children's Services
Children's Residential
School Consultation (for school personnel only)
Speech Therapy
Occupational Therapy
Careers
How to Refer an Individual to Balance Autism
Location
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Altoona
Burlington
Cedar Rapids
Clive
Iowa City
Quad Cities
Waterloo
Type of Service
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Residential
SCL Hourly
Supported Employment
Location
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Des Moines Area
Location
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Cedar Rapids
Des Moines Area
Quad Cities
Location
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Clive
Loved One's Name
Loved One's Age
What type of supports are you seeking?
Staff Only
Submitted By (Email Address)
Contact Information