Contact Form

Parent First Name(Required)

Parent Last Name(Required)

Child's First Name(Required)

Child's Last Name(Required)

Email Address(Required)

Phone Number(Required)

State(Required)

City

Insurance Provider

Child's DOB

Does your child have an autism diagnosis ?(Required)

Yes

Your Message

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.

Get In Touch Today!

Ready to learn more about our ABA therapy program and how we can partner with you to help your child thrive? Contact us today to discuss how our personalized approach to autism therapy can make a difference in your child’s life. We’re here to help every step of the way!

Does your child have an autism diagnosis*?

YesNo

By entering your phone number and clicking 'Submit,' you agree to receive SMS messages from Golden Care Therapy. Message and data rates may apply. You may receive up to 4 messages per month. To Opt-out reply STOP to unsubscribe. For assistance via SMS reply HELP or call us at: (732) 795-5427. As per our Privacy Policy we never share your mobile information with any 3rd parties.

Please leave this field empty.