Admissions

Instructions for INTAKE/RELEASE FORMS

Option 1: Online Application

Immunization Records
Child’s Social Security Card
Birth Certificate
Current Physical (If unavailable, it must be uploaded within 30 days of acceptance.)
Child’s Insurance Card (Required for ABA services)
Parent/Guardian's Driver's License
Childs IEP and Matrix (from current school district)- these can be brought in to Judith to scan and process)

(All documents are required to be uploaded at the time of completing application process)

Save and name the files as follows: {Child's Name} Intake and {Child's Name} Records Request

Please attach the completed forms as PDF files.

Do not send pictures or screenshots, as they are often too dark and difficult to read.

Submitting Your Application:

Once you have completed the online application, please send an email to admin@squarepegsconnect.com, including your child's name in the subject line.

If you have any questions or need assistance with the forms, please reach out to Judith at Square Pegs Admissions by calling 850-270-8411.