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Checks should be made out to MiBAP.

Please send your check to:

Michigan Behavior Analysis Providers (MiBAP)
1100 S Rose St
Kalamazoo MI 49001-2664

Questions? Contact Us at membership@MiBAP.org

MIBAP Membership Application/Renewal Form 2021

PROFESSIONAL INFORMATION

Facility Address(Required)
Primary Contact Name(Required)
Secondary Contact Name

MEMBERSHIP CATEGORY

MiBAP membership dues are determined based on annual ABA services revenue in the state of Michigan. Dues cover membership for a one-year period.
Select a Membership Tier(Required)

MEMBERSHIP AGREEMENT & ATTESTATION

PLEASE READ AND AGREE (Active Members Only)

  Our facility meets the criteria for active membership as described above. We subscribe to the purposes of MiBAP and agree to be abide by its bylaws. Further, I attest to the following on behalf of my organization:

1) We verify BACB certification and Michigan licensure for all behavior analysts and assistant behavior analysts

2) We follow all procedures as established by the state for QBHPs (if applicable for your organization) and they are supervised by a Michigan licensed behavior analyst

3) We perform background checks on all staff and preclude employment of anyone that does meet the requirements of payors and Michigan licensure law for behavior analysts

4) We only use W2 employees as Behavior Technicians; we do not use independent contractors (1099s)

5) We provide all payor-required training to behavior technicians prior to their independent work with clients as outlined in payor contracts

6) We have clear standards and policies for termination of services and completion of client treatment when clinically appropriate

7) We enforce internal policies that align with the standards of the current Ethics Code for Behavior Analysts and the RBT Ethics Code
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Email of Person Attesting to this Membership Agreement(Required)
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