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Intake & Admissions Forms

Help us find the right place for you.

The easiest way to get started with Veritas is to give us a call or complete our general contact form. Our Intake & Admissions Team can answer your questions and, if you’re ready, collect the information we need to begin the admissions process.

If you prefer, however, you can fill out the initial Veritas Intake Form and the Release-of-Information Form using the links below.

Please fill out forms accurately and in their entirety.

We appreciate your time completing these forms so that we can find the best level of care and fit of facility for you or your loved one. All forms will be reviewed by a Master’s-Level Clinician on our Intake & Admissions Team, and you will be contacted within one business day of submission.

Please note that submitting these forms does not in any way commit you to treatment. It simply allows us to learn more about you or your loved one and your treatment needs.

Basic Intake Forms

These two brief forms are required to begin treatment discussions. If you’d like help filling them out, please give us a call.

Veritas Intake Form

This form provides us with the basic information we need about you or your loved on to begin treatment discussions.
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Release of Information Form

This form gives us permissions to talk to your doctors, family members, and others you would like to have involved with your care. Please submit one form for each person.
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Additional Forms

Some of these forms will be required if you choose Veritas treatment for you or your loved one. Again, our Intake & Admissions Team can help you complete them.

Child & Adolescent Preliminary Assessment

This form gives us preliminary insight into the needs of those considering our Child & Adolescent treatment program.
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Adult Preliminary Assessment

This form gives us preliminary insight into the needs of those considering our Adult treatment program.
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Insurance Information

You can find our current list of accepted insurance providers here. Even if your provider is not listed, we can work with them to create a single-case agreement and a care plan that is right for you.
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Healthcare Provider History

This form tells us what medical or clinical treatment you or your loved one may have received in the past six months, whether for an eating disorder or other conditions.
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Custody / Guardianship Documentation

This form is required only if there has been a legal ruling regarding custody or guardianship of an incoming patient.
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