Department of Psychiatry
Penn Behavioral Health

Penn Autism Network

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Supports & Services Form

PAN’s Service Provider Directory

The Penn Autism Network (PAN) receives many inquiries from adults with autism spectrum disorders (ASD) and their families who are seeking supports and services. If you are a service provider to adults and those transitioning to adulthood, please submit your information for inclusion in our directory. If you are not a service provider but would like to share information about a resource to be considered for the directory, give us as much information as possible and we will contact the provider for additional details. PAN will make this directory available in early 2009.

Note: Asterisks (*) indicate required fields



Provider Information

First Name:
Last Name:
Suffix:
Title:
* Organization:
Department:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* County:
* Phone 1:
Phone 2:
Email:
URL:

* Services Offered























 
Ages Served

(indicate all categories served; note that the PAN database is meant to provide resources for adults with autism, those transitioning to adulthood, and their families):






Method of Payment





Service Locations by County
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Person Completing Form

* Name of person completing form:
* Phone of person completing form:
* Email of person completing form:
Additional Info: