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Website
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Admissions Director
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First Name
Last Name
E-mail
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Phone Number
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Area Code
Phone Number
Executive Director
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First Name
Last Name
Academic Director
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First Name
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Clinical Director
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First Name
Last Name
Milieu Director
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First Name
Last Name
Year Founded
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Category
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Please Select
Addiction Recovery
Wilderness/ Outdoor
Residential Treatment Center
Therapeutic Boarding School
Emotional Growth Boarding School
Boarding School for LD
Transition/ Step Down
Young Adult
Other
If other, please explain.
Optimum Size
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Capacity or current number of students if still growing to planned operating size.
Annual number of students
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Average Length of Stay
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How long do students/ residents typically stay in the program?
Admissions Policy
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Year-Round Rolling Admissions? Certain seasons? How fast can enrollment decisions be made? What information do parents need to submit fore you to make an admissions decision?
Appropriate Student/ Resident
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Describe students' behaviors/ issues that are appropriate for your school/ program. Include behaviors not accepted.
Gender
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Please Select
Male
Female
Male & Female Separate
Co-Ed
What Percent Male?
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What Percent Female?
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Age Range
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What is the upper and lower level of age of students/ residents?
Staff to Student Ratio
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Describe the typical staff: student ratio in the classroom, milieu, overnight, etc.
Program Description
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Describe what the students/ residents go through during the program. Levels or phases. Daily activities, milieu, etc.
Clinical Description
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Describe the clinical program, types of therapy, frequency, duration of sessions available to both students and families during the program, etc.
Psychotropic Medications Allowed?
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Please Select
Yes
No
Describe policy/ frequency
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Academic Description
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Describe how you approach academics. Are teachers Masters' level, certified, AP courses, etc.
Facilities Description
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Describe the program property, buildings, living accommodations, amenities, etc. and any offsite facilities the students have access to.
Family Involvement
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What is expected from families of students in your program? What involvement will families have throughout the program?
Follow Up Programming
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What kind of help can the student and family expect after they leave the regular residential portion of your program? Describe the transition from program to what comes next.
Outcome Studies
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Do you participate in 3rd party outcome studies? Explain.
Spiritual Development
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What is available for spiritual and/or faith-based development? i.e. Do students attend church? Is a Rabbi available? Is there special diet available based on spiritual need, etc?
Summer/ Adjunct Program
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Are there any suppliemental resources/ programs that are optional to your program? This might include off site individual counselling, psychotherapy, summer programs, additional off-site activities not normally part of the program.
Professional Affiliations
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Member NATSAP, AEE, TABS, etc.
Accreditation, Licensure, Approved:
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Who is the program licenced, accredited or approved through? List all that apply.
Payment Category
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Percentage of Private pay, 3rd party payments, incurances accepted, government/ school district payments, scholarships, etc.
2016 Tuition
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Basic daily, monthly or anual cost of the program. Include application and enrollment fee, and student account if applicable. This information WILL NOT be published. Is for internal office use only.
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