RBT Initial Competency – Eligibility & Pre-Screen Intake

  • RBT Initial Competency Assessment – Eligibility & Pre-Screen Intake

    This pre-screen form must be completed prior to scheduling your RBT Initial Competency Assessment. The purpose of this form is to verify eligibility requirements, collect required documentation, and confirm readiness for participation in the assessment process. All information submitted is confidential and used solely for assessment documentation and compliance purposes. Required documents must be uploaded with this form. Requests cannot move forward and contracts will not be issued until documentation is received and reviewed.

  • Important Contractual Notice

    The RBT Initial Competency Assessment is provided through our training and professional development program. Participation requires entry into a limited contractual agreement for evaluation services. This service: • does not establish employment • does not establish supervision • does not create an ongoing clinical relationship • does not include the 40-hour training Both the applicant and the BCBA evaluator enter into a professional service contract solely for completion of the RBT Initial Competency Assessment. A formal service agreement must be signed before scheduling.

  • Eligibility Verification

  • Please confirm the following:*

  • Technology & Environment

  • Please confirm the following:*

  • Basic Information

  • Date of Birth*
     - -
  • Format: (000) 000-0000.

  • Training Documentation

  • Date Training Completed*
     - -
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  • Background Screening

  • Have you completed a criminal background screening within the past 180 days?*
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  • If No:*

  • Employment Status

  • Are you currently employed or pending employment with an ABA provider?

  • Assessment Fee

  • Please select your assessment fee option:*

  • Professional Acknowledgment

  • I confirm that all information provided is accurate and complete. I understand I am independently requesting evaluation services. I understand the BCBA is providing this service through a limited contractual agreement and this does not create employment or supervision. I understand the evaluator may decline to sign the competency if standards are not met. I understand certification approval is determined by the BACB.
  • Date*
     - -

  • Next Steps

  • After completing the Pre-Screen Questionnaire and uploading required documentation, eligible applicants may request the service agreement. The service agreement outlines the temporary professional evaluation relationship with OTB Learning Group and must be signed prior to scheduling. Once the agreement is signed, applicants will receive the payment link and available scheduling options for their assessment sessions.

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