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Headquarters

1295 Bandana Boulevard West
Suite 310 & 210
St. Paul, MN 55108
P: 651-645-5323
F: 651-621-8490
Toll-Free: 1-888-364-5977

Custody / Guardianship Documentation

Therapy group

Form

Custody / Guardianship Documentation

If there has been a legal ruling regarding custody or guardianship of an incoming patient, we will need documentation of this prior to admission. Please upload the official court document below.

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

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Healthcare Provider History

Nurse talking to patient

Form

Healthcare Provider History

Who have you worked toward recovery with so far? This gives us a comprehensive view of your current and former providers. Please list any providers that you or your loved one has seen in the past year.

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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Insurance Information

Veritas reception desk lobby

Form

Insurance Information

Cost is an understandably important question when seeking eating disorder treatment. Once we have the details about your insurance provider, our Patient Financial Services team will get started checking your benefits on your behalf.

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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Veritas Intake Form

Inpatient bedroom

Form

Veritas Intake Form

This form provides us with the basic information we need about you or your loved one to begin treatment discussions.

This form includes basic demographic questions in addition to questions about you or your loved one’s eating disorder and your insurance information. If you prefer, we can also complete this over the phone. Please call (855) 875-5812 to schedule an appointment if you do not wish to complete it online.

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