Reset Behavior: Contact Us!

Contact Us!

Reset Behavior is part of the RBX Network Franchise. Services vary per location.
Select your preferred location:*

Las Vegas, NV: Charleston/Summerlin LocationIn Home: General Las VegasIn Home: North Las VegasIn Home: East Las VegasIn Home: Henderson
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Child's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What services are you interested in?*

ABA Therapy ServicesSocial Skills ClassesBehavior Support, Family Training, and/or Home Intervention PlansSpecial Education AdvocacyADOS-2 AssessmentAssessment (Tricare Specific, Outcome Measures, Functional Behavior Assessment/FBA)Schedule a Community TrainingOther
Would you like to be added to our waitlist for ABA therapy services? *
Please select all available time blocks you are available for therapy.*

9:00 am - 1:00 pm9:00 am - 2:00 pm9:00 am - 3:00 pm1:30 pm - 5:30 pm2:30 pm - 5:30 pm3:00 pm - 6:00 pm4:00 pm - 6:00 pmNot ApplicableOther
Please select the day(s) your child is available. (Select All That Apply)*

Available Monday-FridayMondayTuesdayWednesdayThursdayFridayN/A
Please select your preferred therapy location:*

In-ClinicIn-HomeHybrid (In-Clinic and In-Home)Flexible (Either/Or)N/A
Primary Insurance *
Secondary Insurance
Reset Behavior shares your inquiry information and is on a shared waitlist between all of the Las Vegas locations.*

Yes, I understand this submission will be shared between each Las Vegas Reset Behavior location.Yes, I understand this submission will be shared between each Las Vegas Reset Behavior Location. however, I would only like to be on the waitlist for the location selected above.
How did you hear about us? *
How did you hear about us? *
File Upload - Insurance Card and/or Diagnosis

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