We're Here to Help Contact Heartleaf ABA Bangor Office 396 Griffin Rd, Suite 106Bangor, ME 04401Phone: (207) 573-1000Fax: (207) 989-9748Email: intake@heartleafaba.com Provider Referrals We accept referrals from community healthcare providers and case managers. Use the web form below to submit a referral to our Bangor office. Please note that at this time Heartleaf can only provide services for children up to age 6. Provider Name *Provider Email Address *Provider Phone *Street Address *City *State/Province *ZIP / Postal Code *Parent Name *Parent Email *Parent Phone *Street Address *City *State/Province *ZIP / Postal Code *Child's Name *Child's Age *Does the child have an Autism diagnosis?YesNoWhich service(s) are you referring this child for?ABA TherapyDiagnosticsSocial SkillsSpeech & OTSubmit