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Please provide your contact information below and we will connect with you within one business day. You also may call us directly at 1-855-875-5812. If this is an emergency, do not use this form. Call 911 or your nearest hospital.

Get Help for You

    First Name*

    Last Name*

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    Phone*

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    By clicking “Send” below, you are indicating that you understand and agree to these terms regarding the use of your information:

    The information you submit on this form will be used internally for the purposes of processing and responding to your request. It may be routed internally in order to find the most appropriate member of staff to handle your request and your contact information will only be used to respond to your inquiry if you indicate permission to do so.

    In addition, the information submitted may become a part of the patient’s permanent chart or treatment record at Veritas Collaborative upon their utilization of Veritas Collaborative services, and this information may be used in the planning of treatment and care provided to the patient. At the time the patient utilizes Veritas Collaborative services, Veritas Collaborative’s Notice of Privacy Practices and other HIPAA and information privacy and security policies will apply to the information submitted on this form and to any other information that Veritas Collaborative maintains about the patient and the care provided to the patient.

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    Get Help for Your Child

      Parent's First Name*

      Parent's Last Name*

      Email Address*

      Phone*

      How do you prefer to be contacted?*
      PhoneEmail

      Is it okay to leave a message?*
      YesNo


      View Terms

      CLOSE

      By clicking “Send” below, you are indicating that you understand and agree to these terms regarding the use of your information:

      The information you submit on this form will be used internally for the purposes of processing and responding to your request. It may be routed internally in order to find the most appropriate member of staff to handle your request and your contact information will only be used to respond to your inquiry if you indicate permission to do so.

      In addition, the information submitted may become a part of the patient’s permanent chart or treatment record at Veritas Collaborative upon their utilization of Veritas Collaborative services, and this information may be used in the planning of treatment and care provided to the patient. At the time the patient utilizes Veritas Collaborative services, Veritas Collaborative’s Notice of Privacy Practices and other HIPAA and information privacy and security policies will apply to the information submitted on this form and to any other information that Veritas Collaborative maintains about the patient and the care provided to the patient.

      I understand and agree to the terms*.

      This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

      Get Help for a Patient

        Your Contact Information

        First Name*

        Last Name*

        Provider Type*
        MDDietitianTherapistOther

        If other

        Email Address*

        Phone*

        Best way to reach you*
        PhoneEmail

        Contact You or Contact Patient as next step?*
        Contact MeContact Patient

        Patient Information

        Patient's First Name*

        Patient's Last Name*

        Patient's Date of Birth

        Patient’s Phone Number (if age 18 or older)

        If under age 18, please provide a primary parent contact:

        Parent's First Name

        Parent's Last Name

        Parent’s Phone Number

        Is it okay to leave a message?*
        YesNo

        Where Are You Located?

        City*

        State*

        Please share symptoms or concerns for us to note*:

        View Terms

        CLOSE

        By clicking “Send” below, you are indicating that you understand and agree to these terms regarding the use of your information:

        The information you submit on this form will be used internally for the purposes of processing and responding to your request. It may be routed internally in order to find the most appropriate member of staff to handle your request and your contact information will only be used to respond to your inquiry if you indicate permission to do so.

        In addition, the information submitted may become a part of the patient’s permanent chart or treatment record at Veritas Collaborative upon their utilization of Veritas Collaborative services, and this information may be used in the planning of treatment and care provided to the patient. At the time the patient utilizes Veritas Collaborative services, Veritas Collaborative’s Notice of Privacy Practices and other HIPAA and information privacy and security policies will apply to the information submitted on this form and to any other information that Veritas Collaborative maintains about the patient and the care provided to the patient.

        I understand and agree to the terms*.

        This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

        Get Help for a Friend

        Three Ways To Help A Friend With An Eating Disorder

        Take our Eating Disorder Assessment Quiz

        Our Eating Disorder Assessment Quiz takes just a few minutes. It’s a simple tool that helps you to see whether or not you should be concerned. Take the quiz.

        Talk With Your Friend

        Your friend’s health is more important than keeping secrets or shying away from talking to their family. Share your concerns. Be prepared to provide examples of behaviors that alerted you to the problem. And offer the next step—tell your friend to call us at 1-855-875-5812 or show your friend our website to start the journey to healthy living.

        Learn More About Eating Disorders

        We invite family and friends to attend our free Recovery Support community events so you can learn how to play an important role in your friend’s recovery.

        Recovery Starts Here

        If you have questions about anything - eating disorders, our programs, specific needs or concerns - or you'd like to schedule an initial phone assessment or a comprehensive in-person medical assessment, please give us a call or complete our contact form. Our admissions team is here to help.

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