tel 651-259-9750fax 651-259-9790

Supplemental Information

The next step to getting a child/adolescent admitted to the program is the completion of the form below. This allows the Aris Clinic staff to gather the clinical information necessary to determine if the program is a good fit for your child.

The child/adolescent guardian fills out a patient information downloadable questionnaire available here.

After completion this form can be emailed to, faxed to (651) 259-9790, mailed to/dropped off at 7616 Currell Blvd. Suite 100 Woodbury, MN 55125 for the treatment team to review. If the child/adolescent is approved for admission a member of the Aris Clinic team will notify the referring individual and set up an intake date/time. If the individual is not approved for admission the referring individual will also be notified and given alternative resources (if possible) to help the child/adolescent. If you have additional questions please call Aris Clinic staff directly at (651) 259-9750.

If you’re concerned that a child/adolescent is an immediate danger to him/herself, others or significantly disabled, go to the nearest emergency room for an evaluation or dial 911.

Aris Clinic also requests the following information in addition to the Information Questionnaire:

  • Parent/guardian consent (if minor)
  • Custody paperwork/divorce decree (if applicable)
  • Contact information of past and current providers (we may ask to sign a release of information to communicate with these providers)
  • Any past clinical records
  • Insurance information

1 in 5 children ages 13-18 in the U.S. need mental health services; only 20% are likely to receive professional help

Source: National Institute of Mental Health