Sign up

Signing up for Encompass is easy!

Just let us know how you'd like to proceed:

I'm using CLTS waiver funds

I'm using Children's Community Options (CCOP) funds

I'll pay by credit card

I'm not enrolled in CLTS and need help getting started

Sign up

Give us your name and your service coordinator's contact information below and we will get the approval process started right away (look for a letter from us to your Service Coordinator in your email after finishing the form below).

First Name *

Please enter your first name

Last Name *

Please enter your last name

Street Address *

Please enter your street address

City *

Please enter your city

State *

Please enter your state

Zip Code *

Please enter your zip code

Email *

Please enter a valid email

Phone *

Please enter your phone number

Best time to reach you

County *

Please enter your county

Which program are you currently working with? *

CLTS

CCOPS

Please select an option

Waiver (Additional Information Required)

PERSON RECEIVING WAIVER

Name *

Please enter the name

Date of Birth *

Please enter the date of birth

Service Coordinator Name *

Please enter service coordinator name

Service Coordinator Number *

Please enter service coordinator number

Service Coordinator Email *

Please enter service coordinator email

Optional Services to Supercharge Encompass

Most families choose to add Autism United and Gemiini when they join Encompass. Choose which services you would like to add, and we will do the paperwork. No out-of-pocket costs with CLTS or CCOP.

ADD AUTISM UNITED MEMBERSHIP

To gain access to autism-friendly community events, support groups for parents & siblings, and our free resource library.

ADD GEMIINI

To gain access to Gemiini's powerful video modeling tool that enhances therapy outcomes both in clinic and at home.

ADD BOTH

ADD NEITHER

Not enrolled in CLTS?

Share your contact information, and we'll assist you with the enrollment process.

First Name *

Please enter your first name

Last Name *

Please enter your last name

Date of Birth *

Please enter the date of birth

Street Address *

Please enter your street address

City *

Please enter your city

State *

Please enter your state

Zip Code *

Please enter your zip code

Email *

Please enter a valid email

Phone *

Please enter your phone number

Best time to reach you

Great!

Annual subscriptions are offered for $250
Autism United Members can subscribe for $230

I'm a member of Autism United

I'm not a member

Please select an option

(If you become a member in the future, your account will be credited)

Name *

Please enter your name

Street Address *

Please enter your street address

City *

Please enter your city

State *

Please enter your state

Zip Code *

Please enter your zip code

Phone *

Please enter your phone number

Email *

Please enter a valid email

County *

Please enter your county

Thank You!

Your information has been submitted successfully. We'll be in touch soon.