Cancellation Form

Cancellation Form

If an RBT needs to cancel for whatever reason, it is their responsibility to notify the BCBA, client, and school.
Name

First NameLast Name
Client's First Name
Client's Last Name
State
Session Date and Time
Cancelled by
Reason for cancellation
BCBA notified
Client notified
School notified
Make-up Plan

Other
Please note:

* Sessions can never be longer than 8 hours

* Obtain approval for your state director if you'd like to work more than 40 hours in one week
Provide more details on make-up plan
Blue Id
Should be Empty: