Social Skills Groups
To learn more about our Social Skills Groups, or to register your child, please complete the form below and a member of our team will reach out shortly to answer your question, and help you get registered.
Submission ID
Is your child a current client with EAS?
*
Yes
No
If your child is a current client with EAS, please provide their BCBA's name.
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Child Name
*
First Name
Last Name
Child's Age
*
State of Residence
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
In what mode(s) are you interested in doing social skills groups?
Virtually through zoom
In-person at our EAS clinic
If you are interested in an in-person group at our clinic, please let us know what 2 hour time frames would your child be available Monday-Saturday for social skills groups? (example 9am-11am Monday-Friday, but not Saturday)
Submit
Should be Empty: