Waiting List

WAITING LIST APPLICATION

If you just need to just pay the deposit, you can click below.   Otherwise scroll down to fill out the application.

         

Please note that all requested forms and the application fee are required before application will be considered. If forms can not be uploaded, please mail or bring to our offices at one of the addresses listed below.

SOUTH CHARLESTON

Applied Behavior Learning Center
325 6th Ave, SW,
South Charleston, WV 25303

BECKLEY

Applied Behavior Learning Center
1902 Harper Road
Beckley, WV 25801

Accepted Insurance Plans
Aetna Aetna Better Health (Medicaid) (COMING SOON) Anthem/BCBS/Quantum
Blue Cross/Blue Shield Cigna/Evernorth The Health Plan (Medicaid)
Highmark Optum UMR/PEIA
Unicare (Medicaid) Unicare (Traditional) United Health Care

Waiting List Application

Which ABLC Location(Required)
Parent/Guardian Names(Required)
Address(Required)
Days and Times you can attend ABLC
Days and Times you can attend ABLC

The Following must be submitted with this application to be placed on waitlist

Incomplete Applications are not able to be processed
Please check off all items that are attached to this application(Required)

Please Note:

It is the guardian's responsibility to make sure all client file information is kept current. A diagnostic evaluation is needed initially and every two years after. A physicians order and copy of the current IEP is required yearly.
Please read and check each line that shows you have read and understand each statement(Required)
Upload your documents in .pdf, .doc or .docx format
Drop files here or
Accepted file types: pdf, doc, docx, Max. file size: 100 MB.