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Kaiser Permanente Regional Autism Spectrum Disorder (ASD) Center – Rancho Cordova fax number

(916) 631-2553

Autism Spectrum Disorder Center, Department of Psychiatry

Used for: Submitting caregiver/teacher questionnaire for autism evaluation

Fax destination details

Department
Autism Spectrum Disorder Center, Department of Psychiatry
Purpose
Submitting caregiver/teacher questionnaire for autism evaluation
Form
Caregiver/Teacher Questionnaire — Caregiver/Teacher Questionnaire
Address
10725 International Drive, Rancho Cordova, CA 95670
Voice phone
916-631-2550

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fill out the form with the child’s identifying information, concerns, developmental history, and related details; include caregiver and teacher input; return to Kaiser ASD Center.

Official form instructions are published as a downloadable file on the organization's website.

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