Autism Treatment Request Form
Submit authorization requests for initial or updated treatment plans for Autism services.
Download the Autism Treatment Request Form to submit authorization requests for Autism Services. Fax completed forms to
717-851-1414Attn: Care Management or mail to:
Quest Behavioral Health
Attn: Care Management
PO Box 1032
York PA 17405
A Quest Care Manager will review the request and provide a determination. Please contact Quest at
800-364-6352 or 717-851-1480with any questions.