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