How to Refer to Meridell

Please start by calling Intake Services at 800 366 8656 or 512 528 2100

BASIC INFORMATION:

- Brief history

• Parents/guardians & patients names, address(es), phone(s)
• Diagnoses
• Hospitalizations / prior hospitalizations
• Current outpatient
• Current medications

- Specify notable info:

• Known/suspected neurological involvement?
• Explosive? Impulsive? Sexually Acting Out? Cutting?

- Fax clinical information to 512 528 2193, attention Intake

• Psychiatric evaluation
• Psychosocial history
• History & Physical
• Current medications
• Recent laboratory report(s)
• Discharge summary (if any)
• Psychological testing (if any)
• School testing (if any)

- Please complete the SOCIAL HISTORY on line

- Insurance information:

• Name & phone number of insurance company
• Subscribers name, date of birth, employer
• Member ID number

We will guide you through pre-certification with your insurance company.