Admissions Policies | Youth Psychiatric Care in Texas

What to Bring

Items to Bring for Intake

Birth certificate
Social security card
Immunization records
Documentation of dental exam (if completed within the past 12 months)
Last report card
Insurance cards
Any court documents applicable to custody rights of parents or guardians
All current medications (we will review and return those we do not need)
The most recent discharge paperwork (if applicable), specifically regarding medications

Items to Pack

Seven shirts (no midriff, sleeveless, tank tops or band shirts)
Seven pairs of pants or shorts (no ripped or torn pants or leggings, must cover entire thigh)
Seven pairs of underwear and bras (no underwire)
Several pairs of comfortable slip-on or Velcro shoes (athletic, flip flops, shower shoes)
Pajamas, shorts and tee shirts for sleeping
Coat, raincoat, light jacket or hoodie without drawstrings
Personal hygiene products (shampoo, conditioner, body wash, mouth rinse, toothbrush, toothpaste)
Stamps, envelopes, stationary (optional)
Summer only (May-Sep) – swim shoes, one-piece swimming suit
An outfit (shoes included) specifically for the Care Farming – can include older clothing that are seasonal/weather appropriate for activities that require being around animals.
Jeans/shorts or well-fitting sweatpants and T-Shirts
An extra sweatshirt or long-sleeved shirt AND water protective/raincoat for layering as well as Rubber boots/Duck shoes/Rain boots/Wellies are preferred
Shoes should be closed toed and hard soled. Slippers and crocs are not appropriate for working with animals
Cowboy/steel toed boots are still not permitted

Items You MAY Bring

Treatment teams maintain the right to determine the appropriateness of all items
Hairdryers and cordless electric shavers (rechargeable is recommended)
Makeup (see exceptions below)
Cards (basic only, not trading or character cards) and puzzles
Sunglasses and hats
Up to two toys or stuffed animals (no Legos, battery operated or magnetic toys or items)
Books (with therapist approval), journals, coloring books and sketch pads (no metal spirals or magazines)
Up to $20.00 (will be kept in the business office)
Personal pillow, blanket and bedspread (no bed sheets)

Please DO NOT Bring

Belts, shoelaces, clothing with ties, paracords, survival bracelets, bandanas, scarves or ligature items
Cell phones, radios, MP3 players, cameras, flashlights or any electronic devices
CDs, DVDs, videos or tapes, video games or any battery-operated items including watches
Expensive, excessive or irreplaceable jewelry or musical instruments
Razors, knives, sharp edge objects or weapons, false nails or metal barrettes
Matches, lighters, vapors or any type of tobacco products or accessories
Glass items (i.e. compacts or mirrors)
Hard plastic or metal items, picture frames or watches
Steel-toed or cowboy boots
Posters, clothing or books with drug, gang, bands, sexual or demonic content
Snacks or foods unless on a special diet arranged with campus dietitian
Aerosols, nail polish, remover, cologne, perfume or any items containing alcohol
Crayons, markers, pens or permanent marking items
Body or facial piercings, tongue studs, loops or gauges

Give Us A Call

Call Meridell Achievement Center at 512-528-2100 or 800-366-8656 to ask questions or make a referral. We proudly accept TRICARE® and most major insurance coverages.

Intake Form

Information Needed for Admission and Enrollment
Patient’s Name:
First Last
Date of Birth:
MM slash DD slash YYYY
SSN#:
Your Contact Information:
Include all Contact Numbers
Primary Parent/Guardian Name:
Address
Street Address Address Line 2 City State ZIP Code
Phone - Home
Phone - Work
Phone - Cell
Spouse Name:
Phone - Work
Phone - Cell
Email
Other Parent Name if Applicable:
- No Rights
Address
Street Address Address Line 2 City State ZIP Code
Phone - Home
Phone - Work
Phone - Cell
Spouse Name:
Phone - Work
Phone - Cell
Email
Emergency Contact Information:
(Non Parent/Guardian) Other than Listed Above
Name:
Relationship:
Phone Number:
Address
Street Address Address Line 2 City State ZIP Code
Insurance Information:
Subscriber Name:
Subscriber Date of Birth:
MM slash DD slash YYYY
Insurance Co.:
ID/Subscriber #
Employer:
Psychiatrist:
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone number:
Fax number:
Email
Therapist:
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone number:
Fax number:
Email
Primary MD:
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone number:
Fax number:
Email
Any other Release needed for a provider / Probation, Education Consultant etc…
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone number:
Fax number:
Email
Names of Hospitals / Residential Programs Patient has Attended Most Recently:

Name:

City:

State:

Zip:

School:
City/State:
Grade:
State of Birth:
Religion:

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