Required Forms 


A prescription for ABA therapy and a diagnostic report are required by insurance.  We must obtain these 2 documents from the client and submit them to insurance when we request approval to begin ABA therapy.  Both of these documents must be signed by either a MD, DO or PhD (no nurse practitioners, social workers etc.).  
The prescription for therapy must specifically say, "ABA" on it in order for insurance to accept it. 

A diagnostic report is a 10-15 page report that explains the testing that was completed and scores obtained in order to arrive at the diagnosis(es).


Submission Options


1. Online

For online submission, complete the 2 links below. Both forms must be completed in their entirety before submission. 



We Are Currently at Capacity. Please complete the required forms below in order to join our Waiting List.



Positive Vibes ABA serves all ages.  We accept all forms of TennCare, some private insurance, and private pay. 

Clinical Indicators 

Clinical indicators are measures of the process, structure, and/or outcomes of patient care. They are used by health systems and services, as well as accreditation and regulatory bodies, to identify areas of concern that might require further review or development.


2. Paper Version 


For paper submission, click on the link below, download forms, print and complete, and submit via email, fax, or mail. Both forms must be completed in their entirety before submission. 



Paper Download Click Here

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T: 423.375.9192
Fax: 833.379.4405

Office address:

2020 Meadowview Parkway

Suite 100 and 110

Kingsport, TN 37660

Mailing Address:

1657 E. Stone Dr. 

Suite B Box 151

Kingsport, TN 37660

© 2019 Positive Vibes ABA Therapy

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