Child’s Intake Checklist

Here’s a list of items you must bring to your child’s intake appointment for any of our residential programs.

The first four items on this list are required. If you do not bring these items, your child will not be admitted and you will be asked to reschedule the intake.

Items to Bring to Your Intake Appointment

1. EPSDT Medicaid Referral for Services (if child is on Medicaid) required
2. Copy of recent physical exam (within the last 6 months to a year) required
3. Recent TB screen required
4. Immunization records required
5. Insurance or Medicaid card
6. Social Security card
7. Birth certificate
8. Current medication/s, preferably prescriptions or bubble packed
9. Withdrawal sheet from your child’s school (because they will be enrolled in our school system)
10. Credit or debit card (can be a prepaid card) that you will use to set up an account at Walgreen’s Pharmacy in order to cover any medication co-pays/other expenses not covered by your child’s insurance