Many times, our admissions staff needs more information than a completed application. For this reason, a release of information form is available below. When signed by the child’s legal guardian, it allows Shodair Children’s Hospital to request records, like medication notes, psychological evaluations, therapy notes, or school reports. This information helps us decide if we can admit your child for treatment at Shodair.
Admissions to the Residential Unit:
If you have a child who is not functioning well at home, in the community, or at school, and is experiencing severe symptoms despite professional treatment, please call us directly at 1-(800)-447-6614 or (406) 444-7521 for personal assistance from our admissions staff. You may also start the referral process by filling out the form below.
Please fill out the application and release of information forms with as much detail as possible. For example, instead of saying "aggressive behaviors," describe what the behaviors are (hitting, biting, kicking, etc.), how frequently they occur, the last time it happened, how long it lasts, who/what the behaviors are aimed at (peers, parents, siblings, teachers, toys, furniture, etc.), known triggers, etc. Having this information helps speed up the evaluation process.
Mail back or fax to:
Shodair Children’s Hospital
P.O. Box 5539
Helena, MT 59604
Fax: (406) 444-1039
*Please note we are not able to accept this information by e-mail.