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Professional Referral Forms

Professional Referral Forms

Referral Information for Trauma and Eating Disorders Admissions

Admissions to The New Orleans Institute and The Eating Disorders Treatment Center at River Oaks Hospital are scheduled for patients if they meet the clinical and medical criteria that our treatment teams and their insurance companies deem necessary. Certain medications, medical complications, and substance abuse issues could delay or prevent an admission. Both of these programs are highly cognitive and require a high degree of focus to attain treatment goals.

Referral Forms are available below or by request. They should be completed by a member of the candidate’s outpatient treatment team (i.e. physician, therapist, case manager, nutritionist, social worker). These forms were created as a best practice from over 20 years of providing care. Each line item is important for the treatment teams to help better understand the candidate’s needs and our ability to meet them.

The Eating Disorders Treatment Center Clinical Intake form
The New Orleans Institute Patient Referral form

Also, please note the following when filling out referral forms:

  • Smoking is not allowed in either of these programs.
  • Incomplete forms may delay a complete review and response about appropriateness of admission to either of these programs.
  • Once the forms are completed, please fax to 504-733-3229 or email: .
  • Patients must have an outpatient therapist and physician prior to admission to ensure a successful discharge plan. In the case of The Eating Disorders Treatment Center, we also recommend a nutritionist.
  • Patients must have a safe home to return to post discharge.

Please note that the average length of stay for each program is 30 days, yet always depends upon the patient’s clinical needs, presentation, and progress towards goals. Although this average is longer than most acute care facilities, our specialty unit programs are still a part of the inpatient network at River Oaks Hospital; therefore, inpatient security standards and observation rounds apply.

Referral Information for Adult Psychiatric Program, Dual Diagnosis/Addictive Disorders, Adolescent Program, and PHP/IOP

Anyone can make a referral to many of the programs at River Oaks Hospital. When an outpatient provider is involved with treatment, it is usually helpful when that is established at the start of the admission process. The form below can help to ensure that a solid discharge plan is established with outpatient providers upon discharge as well as be involved with treatment is needed. Please note that submission of this form does not guarantee program availability, only to assist in streamlining an admission.