I. Basic Criteria for Admission

  • Adolescent girls and adult females, 13+
  • Primary diagnosis of eating disorder
  • Co-existing mental and emotional illness
  • Low body weight and/or low BMI are acceptable
  • Cardiac functions must be stable

II. Requested Information from referral source

  • Release of Information
  • Patient mental health and medical history
  • Current medications
  • Recent lab results, if available. Labs will be done upon admission

III. Referral Process

  • Fill out and submit the form below or click here to print and fax this form and required information to 801-224-8301, Attn: Admissions
  • CFC will call to confirm that we received the documents
  • CFC will call to check insurance benefits
  • CFC will call the client to schedule an assessment
  • CFC will call to let the Referral Source know the date of the assessment
  • CFC will call to let the Referral Source know the outcome of the assessment and treatment recommendations
  • Upon admission, CFC will call the Referral Source with an update on the client and give the names of the assigned therapist and dietitian.
  • Shortly after admission, CFC will send the Referral Source a letter with the signed release of information, the patient code, and the CFC treatment team’s contact information.


  • Client Information

  • MM slash DD slash YYYY