GANE
Grupo de Apoyo para Niños Especiales
4115 N. 108th Ave., Ste. 105 Phoenix, AZ 85037
Tel: (602) 274-4263

GALA
Grupo de Apoyo para Latinos con Autismo
P.O. Box 13425 • Tempe, Arizona 85284-0058
Tel: (602) 513-6243
Correo electronico: info@arizonagala.org

Refer a Family

Do you or someone you know need our assistance?

Family Referral Form

Choose a language to translate this form.


Instead of using this form, please email the referral directly to pfcreferrals@encirclefamilies.org so we can support the family as quickly and smoothly as possible. Thank you for referring families to our PFC program!
Professional Information






Family Information


















By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. You will receive no more than two attempts to reach you via SMS text message. Message & data rates may apply. You can reply STOP at any time to opt-out of further messaging. For help, please call 602-242-4366.
Optional Information
This information helps us ensure that we are serving our entire community. This section is optional and has no impact on the availability of services from Encircle Families. Our services are always available at no cost to all Arizona families.



Examples include free school lunches, Income-based AHCCCS, SNAP.


Contact Information