Book an Intake Call – Talkalerts llc

Schedule a brief intake call with Talk Alerts to learn more about TeleABA parent training, self-pay consults, and available options for your family.
During this call, we’ll review your goals, explain how our services work, and help you decide on the best next step.

Note: This form is for basic information only. Please do not share detailed medical history or insurance ID numbers here.

Parent/Caregiver Information

Parent/Caregiver Name (required)

Email Address (required)

We’ll send confirmation and follow-up details to this email.

Phone Number (required)

Preferred Method of Contact (required)

Location & Service Context

State You Live In (required)

Insurance-covered services are available in North Carolina (active) and Texas (pending). Other states may be eligible for self-pay.

What are you interested in? (required)
Insurance-covered parent training
Self-pay TeleABA consults
Online courses / Talk Alerts Academy
Not sure yet – I would like guidance

Child / Family Context

Child’s Age Range (required)

What would you like help with? (required)

Examples: daily routines, communication skills, behavior concerns, parenting support, school challenges, questions about ABA or services.

Preferred days/times for an intake call (optional)

Example: “Weekdays after 4pm” or “Tuesday/Thursday mornings.”

Required Acknowledgements

I understand that Talk Alerts Consulting LLC provides educational and coaching services through Licensed Behavior Analysts, not medical care. This intake call is for information and service planning only and is not a substitute for individualized ABA therapy, emergency services, or a diagnostic evaluation.

I agree not to include my full insurance ID number, Social Security number, or detailed medical history in this form. I understand that, if services move forward, more detailed information may be collected later through a secure, HIPAA-conscious process.

I consent to being contacted by Talk Alerts Consulting LLC regarding my intake request and available service options.

Privacy Note:
This form is designed to collect only basic information so we can schedule and prepare for your intake call. Please do not include full insurance ID numbers, Social Security numbers, or detailed medical history. If services move forward, additional information will be gathered using secure, HIPAA-conscious systems.