SCHEDULE A TOUR
We'd love to welcome you and your family to our Houston center. During your visit, you'll meet our clinical team, tour our therapy spaces, learn about our ABA, speech, and in-home therapy services, and have the opportunity to ask questions about insurance, enrollment, and next steps. Tours are available Tuesday through Friday from 11:00 AM to 2:00 PM. Simply complete the form below, and a member of our Client Services team will contact you to confirm your visit.
Parent/Guardian Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child Name
*
First Name
Last Name
Date of birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Insurance Type
*
Please Select
Blue Cross Blue Shield (BCBS)
Cigna
Aetna
Texas Medicaid
Wellpoint (formerly Amerigroup)
Superior Health Plan
Ambetter
TRICARE / TriWest
Claritev
MultiPlan
PHCS (Private Healthcare Systems)
Community Health Choice
Molina Healthcare
Texas Children's Health Plan
Other
Number of Attendees
*
Please Select
1
2
3
4+
Select Appointment Time
*
How did you hear about us?
*
Google Search
Referral from Dr's Office
Community Event
IG/Facebook
Family/Friend
Other
Consent to Contact
*
I consent to be contacted by Chivalry ABA regarding this tour request
Save
Submit
Should be Empty: