Behavior Technician Registration

Interested in joining our clinical team? Complete the form below and we’ll follow up with next steps.

Please provide your full legal name associated with your BCBA certification *

Email *

Will you now or in the future require sponsorship? *

YesNo

Please share your address *

License *

Are you a Board Certified Behavior Analyst? *

Yes, certification is current.No, certification is expired.No, certification is in progress (BCaBA).No, I'm not a BCBA.

For verification purposes, please share your NPI number below *Enter your 10-digit NPI number

In which states, if any, are you currently licensed as an LBA? *

Have you been hired by us in the past and/or signed an offer or contract with our company?

YesNo