Please Read Below Before Filling Out this Form!

This form allows county workers, parents, or foster providers to be put on OBC's wait list for behavior consultation services (these services are listed here). This form is NOT for trainings or general requests for one-time consultation. Please contact Nate here if that is what you are looking for!

Please read all of the following before filling out the form

1) Please note that we are only accepting clients with diagnosed or suspected Fetal Alcohol Spectrum Disorders (FASDs) or exposure to drugs while in utero. While I appreciate the many referrals I receive for all developmental disabilities, this is the population I am currently serving. I will consider clients with other developmental disabilities only if no other consultants can be found. Please know the my waiting list is generally out 5-6 months. If you have an emergency behavioral issue please contact OBC directly, or indicate that this is an urgent situation on the form below. While I cannot do emergency Functional Assessments and Behavior Support Plans, I am happy to provide consulting if the counties can provide the funding and approval to do so before an FA has been completed.  

2) Due to my busy schedule, I cannot spend a lot of time following up with unresponsive providers/families. Please only refer families to me who will engage in services when they come up on the waitlist. It may be helpful to send them the OBC Youtube Channel so they can see my approach and the direction I go in for services. If families do not respond, I move to the next client who has been waiting on the waitlist. 

3) It is my practice to release Functional Assessments (FAs) and Behavior Support Plans (BSPs) at the same time (if the FA suggests a BSP). This is done for quality-assurance purposes and to shorten the amount of time families wait for plans. If you expect me to wait to write the BSP until after the team reads the FA, you must communicate that with me upon referral

4) After your client is accepted on the waitlist, please send me the following: (if you are a parent or foster provider, your county CDDP can usually do this)

  • All psychological evaluations and psychological testing
  • Any documentation that outlines trauma and history
  • Individualized Support Plan (ISP)
  • Risk Identification Tool (RIT)
  • Person Centered Information
  • Mental health progress notes
  • Incident reports for the past 1-2 years
  • Anything else you think would be helpful!

 

Thank you so much for considering Oregon Behavior Consultation!

 

Your Name *
Your Name
Your Phone Number *
Your Phone Number
You are a: *
What are THE INITIALS of the client or individual you are referring? (PLEASE DO NOT USE FULL NAMES HERE!)
The client/individual needs the following services: *
What is the client's disability or condition? *
Does the client speak to communicate? *