headstart.health
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Submitted URL: https://old.headstart.health/
Effective URL: https://headstart.health/
Submission: On June 09 via api from US — Scanned from DE
Effective URL: https://headstart.health/
Submission: On June 09 via api from US — Scanned from DE
Form analysis
2 forms found in the DOMName: wf-form-Contact-Form — GET
<form id="wf-form-Contact-Form" name="wf-form-Contact-Form" data-name="Contact Form" method="get" class="contact-form-base" data-wf-page-id="664cead0787f508561b4f322" data-wf-element-id="4405ae9f-e72f-bcdd-d3ff-ea2702b5755b" novalidate="novalidate"
aria-label="Contact Form">
<div class="sec-heading-wrap contact-popup-head">
<h4 class="heading-h5">Contact Us</h4>
</div>
<div class="contact-form-wrap">
<div class="contact-form-grid">
<div id="w-node-_4405ae9f-e72f-bcdd-d3ff-ea2702b5755e-02b57550" class="contact-field-wrapper">
<div class="fild-lable">First Name</div><input class="contact_form-field w-input" maxlength="256" name="Full-Name" data-name="Full Name" placeholder="First Name" type="text" id="Full-Name-3" data-msg="Please enter first name" required="">
</div>
<div id="w-node-_4405ae9f-e72f-bcdd-d3ff-ea2702b57562-02b57550" class="contact-field-wrapper">
<div class="fild-lable">Last Name</div><input class="contact_form-field w-input" maxlength="256" name="Last-Name" data-name="Last Name" placeholder="Last Name" type="text" id="Last-Name" data-msg="Please enter last name" required="">
</div>
<div id="w-node-_4405ae9f-e72f-bcdd-d3ff-ea2702b57566-02b57550" class="contact-field-wrapper">
<div class="fild-lable">Email</div><input class="contact_form-field w-input" maxlength="256" name="Email-Address" data-msg-required="Please enter your email address." data-name="Email Address" placeholder="Enter email address" type="email"
id="Email-Address-3" required="">
</div>
<div id="w-node-_4405ae9f-e72f-bcdd-d3ff-ea2702b5756a-02b57550" class="contact-field-wrapper">
<div class="fild-lable">Phone Number</div><input data-msg-pattern="Please enter valid mobile number" class="contact_form-field w-input" maxlength="15" name="Phone-Number" data-msg-required="Please enter mobile number" data-name="Phone Number"
min="0" placeholder="Enter your phone number" minlength="10" type="number" id="Phone-Number-3" required="">
</div>
<div id="w-node-_4405ae9f-e72f-bcdd-d3ff-ea2702b5756e-02b57550" class="contact-field-wrapper">
<div class="fild-lable">How Can We Help?</div><textarea id="Message-3" name="Message" maxlength="5000" data-name="Message" placeholder="Write here
" class="contact_form-field text-area w-input"></textarea>
</div>
</div>
</div><input type="submit" data-wait="Please wait..." class="submit_button w-button" value="Submit">
</form>
Name: wf-form-Join-Our-Waitlist-Form — GET
<form id="wf-form-Join-Our-Waitlist-Form" name="wf-form-Join-Our-Waitlist-Form" data-name="Join Our Waitlist Form" method="get" class="waitlist_form-base" data-wf-page-id="664cead0787f508561b4f322"
data-wf-element-id="6db14a36-29f8-2522-2ade-cdaba1267d45" novalidate="novalidate" aria-label="Join Our Waitlist Form">
<div class="sec-heading-wrap contact-popup-head">
<h4 class="heading-h5">Join Our Waitlist</h4>
</div>
<div class="contact-form-wrap">
<div class="contact-form-grid">
<div id="w-node-_6db14a36-29f8-2522-2ade-cdaba1267d4d-a1267d44" class="contact-field-wrapper">
<div class="fild-lable">First Name</div><input class="contact_form-field w-input" maxlength="256" name="First-Name" data-name="First Name" placeholder="First Name" type="text" id="First-Name-5" data-msg="Please enter first name" required="">
</div>
<div id="w-node-_6db14a36-29f8-2522-2ade-cdaba1267d51-a1267d44" class="contact-field-wrapper">
<div class="fild-lable">Last Name</div><input class="contact_form-field w-input" maxlength="256" name="Last-Name" data-name="Last Name" placeholder="Last Name" type="text" id="Last-Name-5" data-msg="Please enter last name">
</div>
<div id="w-node-_6db14a36-29f8-2522-2ade-cdaba1267d55-a1267d44" class="contact-field-wrapper">
<div class="fild-lable">Phone Number</div><input data-msg-pattern="Please enter valid mobile number" class="contact_form-field w-input" maxlength="15" name="Phone-Number" data-msg-required="Please enter mobile number" data-name="Phone Number"
min="0" placeholder="Enter your phone number" minlength="10" type="number" id="Phone-Number-7">
</div>
<div id="w-node-_6db14a36-29f8-2522-2ade-cdaba1267d59-a1267d44" class="contact-field-wrapper">
<div class="fild-lable">Email</div><input class="contact_form-field w-input" maxlength="256" name="Email-Address" data-msg-required="Please enter your email address." data-name="Email Address" placeholder="Enter email address" type="email"
id="email-join" required="">
</div>
<div id="w-node-_6db14a36-29f8-2522-2ade-cdaba1267d5d-a1267d44" class="contact-field-wrapper">
<div class="fild-lable">What is your zipcode ?</div><input class="contact_form-field w-input" maxlength="256" name="What-Is-Your-Zipcode" data-msg-required="Please enter your zipcode" data-name="What Is Your Zipcode ?"
placeholder="Enter your zipcode" type="text" id="What-Is-Your-Zipcode-5">
</div>
<div id="w-node-_6db14a36-29f8-2522-2ade-cdaba1267d61-a1267d44" class="contact-field-wrapper">
<div class="fild-lable">Which of the following best describes you?</div>
<div class="contact_radio-holder"><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Describes-you" id="I-m-looking-to-receive-therapy-for-myself-or-a-family-member"
data-name="Describes you" style="opacity:0;position:absolute;z-index:-1" value="I’m looking to receive therapy for myself or a family member"><span class="w-form-label"
for="I-m-looking-to-receive-therapy-for-myself-or-a-family-member">I’m looking to receive therapy for myself or a family member</span>
</label><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Describes-you" id="I-m-a-care-provider-looking-to-partner-with-Headstart"
data-name="Describes you" style="opacity:0;position:absolute;z-index:-1" value="I’m a care provider looking to partner with Headstart"><span class="w-form-label" for="I-m-a-care-provider-looking-to-partner-with-Headstart">I’m a care
provider looking to partner with Headstart</span>
</label><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Describes-you" id="Other" data-name="Describes you"
style="opacity:0;position:absolute;z-index:-1" value="Other"><span class="w-form-label" for="Other">Other</span>
</label></div>
</div>
<div radios="role" id="w-node-_6db14a36-29f8-2522-2ade-cdaba1267d71-a1267d44" class="contact-field-wrapper">
<div class="fild-lable">Which of the following best describes your role as a care provider?</div>
<div class="contact_radio-holder"><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Role" id="BCBA" data-name="Role" style="opacity:0;position:absolute;z-index:-1"
value="BCBA"><span class="w-form-label" for="BCBA">BCBA</span>
</label><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Role" id="BCaBA" data-name="Role" style="opacity:0;position:absolute;z-index:-1"
value="BCaBA"><span class="w-form-label" for="BCaBA">BCaBA</span>
</label><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Role" id="RBT" data-name="Role" style="opacity:0;position:absolute;z-index:-1" value="RBT"><span
class="w-form-label" for="RBT">RBT</span>
</label><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Role" id="Speech-Therapist-Occupational-Therapist-Speech-Language-Pathologist" data-name="Role"
style="opacity:0;position:absolute;z-index:-1" value="Speech Therapist / Occupational Therapist / Speech Language Pathologist"><span class="w-form-label" for="Speech-Therapist-Occupational-Therapist-Speech-Language-Pathologist">Speech
Therapist / Occupational Therapist / Speech Language Pathologist</span>
</label><label class="contact_radio-field w-radio">
<div class="w-form-formradioinput w-form-formradioinput--inputType-custom contact_radio-butoon w-radio-input"></div><input type="radio" name="Role" id="Other-2" data-name="Role" style="opacity:0;position:absolute;z-index:-1"
value="Other"><span class="w-form-label" for="Other-2">Other</span>
</label></div>
</div>
</div>
</div><input type="submit" data-wait="Please wait..." class="submit_button w-button" value="Submit">
</form>
Text Content
AboutFor ProvidersContact Us Sign In Family Sign In Provider Sign In CONNECTING FAMILIES WITH HIGH-QUALITY ABA THERAPY Get Started WE ACCEPT MOST INSURANCE, INCLUDING COMMERCIAL AND MEDICAID THE HEADSTART APPROACH FAMILIES FIRST At Headstart, your family is our priority. We know how difficult it can be to find a great care provider – we’re here to help find your fit. CLINICIAN-LED Each Headstart clinician owns their practice and treats each client individually, based on their needs. No standardized treatment plans – your child is one-of-one, and their therapy should be no different! WHERE YOU WANT IT, WHEN YOU WANT IT We’re focused on bringing excellent ABA therapy to the comfort of your own home. Just set your schedule, and we’ll take care of the rest. YOUR CHOICE ABA therapy is highly personal, and we know how important it is to find the right fit. Speak to different care providers and choose the one best suited to your needs. Sign Up for Headstart GETTING STARTED 1 Pick a Provider Take a look at Headstart’s rockstar providers and select who you’d like to speak with 2 Create an Account Don't worry, it should only take a couple minutes 3 Reach Out Reach out to your provider of choice to schedule a consultation 1 Pick a Provider Take a look at Headstart’s rockstar providers and select who you’d like to speak with 2 Create an Account Don't worry, it should only take a couple minutes 3 Reach Out Reach out to your provider of choice to schedule a consultation LOOKING TO START A PRACTICE? We help BCBAs build, manage, and grow their own independent ABA practices. PRACTICE FORMATION Everything from forming an LLC to getting liability insurance CONTRACTING & CREDENTIALING We'll get you in-network with the major insurance plans SOFTWARE TOOLS We offer the full suite of clinical and administrative software tools needed to run your practice END TO END SUPPORT Always ready to help find new clients, recruit RBTs and everything in between Take your practice farther and faster with Headstart Learn More Ready to get started? Get Started Questions? Contact Us AboutFor ProvidersPrivacy Policy ©Headstart Health, Inc. 2024. * * * * CONTACT US First Name Last Name Email Phone Number How Can We Help? Thank you for submitting the form! Your details have been received. We'll be in touch with you shortly. Okay Oops! Something went wrong while submitting the form. JOIN OUR WAITLIST First Name Last Name Phone Number Email What is your zipcode ? Which of the following best describes you? I’m looking to receive therapy for myself or a family member I’m a care provider looking to partner with Headstart Other Which of the following best describes your role as a care provider? BCBA BCaBA RBT Speech Therapist / Occupational Therapist / Speech Language Pathologist Other Thank you for submitting the form! Your details have been received. We'll be in touch with you shortly. Okay Oops! Something went wrong while submitting the form.