Adler Center For Special Needs
Our Intake Process
All our programs begin with an Intake Form/Questionaire (on right) that
allows us to determine the skills that your child already possesses, as
well as those in need of strengthening. Once we have a comprehensive
understanding of your child’s needs, we are able to develop an
individualized curriculum.
Documents such as IEP's (Individualized Education Plans) and
BIP's (Behavior Intervention Plans) help us develop short-term
goals and objectives.
How to Set Up Your Child’s Intake.*
The following are options you can choose to access and submit your child's
intake forms.
• Through Our Website: Please download, complete and SAVE the form above. You can bring
the completed form with you at the time of the interview or email it back in advance by attaching
and sending to: Sharon Hanover, shanover@miyjcc.org.
• Call The Adler Center Office: (516) 822-3535, x303
• Pick up an Intake Form at the MIYJCC: 45 Manetto Hill Road, Plainview, NY 11803
Once the form is submitted, you will be contacted to schedule an interview with you and your child.
Please include a copy of your child’s IEP (Individualized Education Plan) and BIP (Behavior Intervention Plan) when mailing in or dropping off forms, or you can bring them with you at the time
of the interview.
*All information is kept strictly confidential.
Note: Ask your health insurance provider if they offer reimbursement for services.
Try A Class For Free
Following your interview, your child is welcome to try out a free class prior to registration. This is a great introduction into the program and allows your child and our staff to get to know each other.
GETTING STARTED
INTAKE FORM
Please Download,
complete and SAVE
the above form
before submitting.
