Do your students receive insurance coverage for more than two weeks?

Do you have an insurance utilization person?

Is the program on any insurance panels?
N/A

State and/or National
N/A

Academic Accreditation
N/A

Wilderness Therapy Model

Number of Phases or Levels

If program has phases/levels, are they tied to privileges?

Percentage of students who complete all phases/levels prior to leaving the program

Average Length of Stay
0

Religious Affiliation
N/A

Is there individual therapy?

Number of individual therapy hours student receives on a difficult week?
0

Number of individual therapy hours student receives on typical week?
0

Percentage of licensed therapists?

Therapist average case load
0

Percentage of full time therapists who have a private practice outside a program?

Does the Clinical Director carry a case load?
N/A

Is there group therapy?
No

Average number of hours per week facilitated by licensed therapist
0

Average number of hours per week of group processing? (i.e. run by staff, interns, grad students, etc.)
0

Average number of formal family therapy hours per week (not social calls to teen)
0

Is Skype accessible for family therapy?
N/A

Are there Additional Professionals? (Select all that apply)
N/A

Are there Medical rule outs
N/A

Possible Medical Rule Outs
N/A

Is there a minimum BMI
N/A

Can Program accept insulin-dependent diabetics
N/A

Psychiatrist

Percentage of students on meds at enrollment

If psychiatrist is available to students, what percentage of students change meds?

Types of Therapy Offered
N/A

Does the program have a level/phase system?
N/A

If yes, are phases/levels tied to privileges?

Does program have a milieu-driven residential model? (Staff are trained in model)
N/A

If yes — select all that apply
N/A

Integrated Wellness
N/A

Does program use time out rooms?
N/A

Line staff to student ratio during awake hours
1:0

Does program run background checks on all staff?
N/A

Is there an educational requirement for staff?
N/A

If Yes, what is it?

Average number of hours staff are trained before their first shift
0

Are night staff awake or asleep

What percentage of the line staff are full time employees?

Grades Served
N/A

Average student to teacher ratio
1:0

Teaching/Classroom
N/A

Is the program able to implement IEP’s

Can Program handle a student who is more than two grade level’s behind in reading?

Academic Calendar

Can program support a student to complete a GED?
N/A

Can program support a student who wants vocational training?

Does the school have AP Classes or the ability to give or take a student to the AP Test?
N/A

Does the academic program have the ability to provide ACT or SAT Tutoring (on or off site)?

Does program have transition services for students?
N/A

If Yes, select all options that apply to your program
N/A

Are there additional fees that apply to transitional options?

Percentage of families that participate in various transition programming?

Scheduled or rolling admissions?

Is there an enrollment fee/outfitting fee/payment in advance?

If applicable, is the last month’s fees due at enrollment?

Cost per month/workshop/programming (in USD)
N/A

Percentage of clients who return home, or to a more traditional setting (like transitions to college or gap year, boarding school, etc.)

Does a student have to sign themself into the program?
N/A

Link to Weekly or Daily Schedule
N/A

For licensed programs, but state or under 18, please select Incidents required to be reported to the state:
N/A

What is the typical amount of time a family should expect before hearing about an major incident?
N/A

What is the average number of clients you see per year?
N/A

Professional Associations/Affiliations
N/A

Payment Type
N/A

Has the program previously been part of an evidence-based study?

Is the program presently part of an evidence-based study?
N/A

Link to the study that the organization is part of
N/A

Type of Family Therapy/Work Offered
N/A

Family involvement

Who completes the psychological evaluation?

Minimum length of stay
N/A

Does the student receive a neuropsychological evaluation?

Type Of Programming For Students
N/A

Typical Student
N/A

Minimum IQ
N/A

Interview Requirements for Applicants
N/A

Additional Therapy

Therapist Case Load at Peak Season

Percentage of licensed therapists?

Average number of days/week therapist is in the field
N/A

Number of Individual Sessions with Therapist
N/A

Integrated Wellness Support
N/A

Do clinical assistants work with lead therapists?
N/A

Percentage of full time therapists who have a private practice outside of wilderness?

Do any of the therapists operate more than one group at peak season?
N/A

What percentage of participants receive psychological evaluations?

Does program receive a fee for evaluation or referral?
N/A

Additional levels of care offered by facility

Types of eating disorder care provided
N/A

Specialized Programming
N/A

Is program focused on full recovery?

Housing
N/A

Community Service Requirement

Random Drug Testing
N/A

Transportation Options
N/A

Support Services

House/Community Meetings

Are participants required to do chores in the house/community?

12 Step Meetings on Location
N/A

Type of Students

Computer Access
N/A

Cell Phones
N/A

Academic Options

School Name (if applicable)
N/A

School Website (if applicable)
N/A

Types of Workshops Offered
N/A

Accommodations
N/A

Use of Personal Vehicle

Use of Electronics

Location of Workshop

Average Length of Workshop

Professional Associations/Affiliations
N/A