Pediatric Behavioral Intervention Consent Form

Streamline Pediatric ABA Therapy Consent with Paperform

When families seek behavioral intervention services for their children, the intake process needs to be clear, thorough, and reassuring. This Pediatric Behavioral Intervention Consent Form template is designed specifically for ABA therapy providers, pediatric behavioral health clinics, and developmental intervention centers who need to collect comprehensive consent, authorization, and scheduling information in one professional, HIPAA-compliant form.

Built for behavioral health providers who care about families

This template captures everything you need before beginning ABA therapy services: treatment consent, HIPAA authorization for information sharing, insurance approval details, data collection permissions, and progress monitoring schedules. Instead of juggling multiple paper forms and email threads, families can complete everything in one place—and you get structured data that feeds directly into your practice management system.

Paperform's conditional logic ensures families only see the questions relevant to their situation. For example, insurance fields appear only when needed, and data collection consent expands based on the specific monitoring methods you'll use. The doc-style editor lets you include reassuring language, explain ABA methodology clearly, and embed helpful videos or resources right alongside consent checkboxes.

From consent to signed agreement in one workflow

Once a family submits this form, you can use Papersign (papersign.com) to automatically generate a formal consent agreement based on their responses and send it for secure eSignature from both parents or guardians. This creates a complete audit trail from initial intake through signed authorization—all linked back to the original form submission.

For ongoing care coordination, connect this form to Stepper (stepper.io) to trigger your intake workflow: notify clinical staff, create a client record in your EHR, schedule the initial assessment, and send welcome materials to the family. Because ABA therapy involves insurance pre-authorization and frequent progress reviews, automation ensures nothing falls through the cracks while your clinical team focuses on delivering quality care.

Trusted by behavioral health providers

Paperform is SOC 2 Type II compliant and offers the security controls behavioral health practices need, including data residency options, role-based permissions, and integration with major CRMs and practice management platforms. Over 500,000 teams worldwide trust Paperform to handle sensitive client information with care.

Whether you're a solo BCBA building your practice or a multi-site clinic onboarding dozens of families each month, this template gives you a professional, compliant starting point that you can customize to match your specific consent requirements, state regulations, and clinical protocols.