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ÂÒÂ×ÉçÇø Children’s Health Comprehensive Eating Disorders Program

Tel: (800) 995-5724

You can register for ÂÒÂ×ÉçÇø Children's Health MD PortalÌý() to submit referrals and track appointments online.

* Required

The following information is necessary to process your referral

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*Please note we recommend height, weight, temperature, and orthostatic blood pressure be done on a weekly basis or as clinically indicated.

Any patient with a history of purging or laxative abuse should at a minimum have a basic metabolic panel, phosphorous, and magnesium level checked for electrolyte abnormalities.

We recommend that patients are weighed in gown only, after voiding. Orthostatic vital signs are assessed by having patients lay down for 5 minutes, then measuring pulse and blood pressure (P&BP). Then the patient should stand, and P&BP are repeated after 2 minutes.ÌýÌý

Referring Provider

Reason for Referral

Note—supine and standing orthostatic vital signs preferred. If not available, ok to use sitting P&BP

Pulse:

(if orthostatics unavailable)

Blood pressure:

(if orthostatics unavailable)

Required Patient Information
Admission Criteria

Adolescents with eating disorders or malnutrition who meet any of these criteria may be candidates for inpatientÌýtreatment:

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Bradycardia

Pulse < 50 beats/minute at daytime,

Pulse < 45 beats/minute at night
Hypotension BP < 90 / 45 mm Hg
Hypothermia T < 35.6 °C / 96 °F

Orthostasis

(from supine to standing position)*

 Pending review of case

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Weight

< 75% median body mass index (mBMI) for age and sex
EKG abnormalities EKG abnormalities
Electrolyte abnormalities
  • Phosphorus < 3.0 mg/dL
  • Potassium < 3.5 mmol/L
  • Magnesium < 1.8 mg/dL

Other acute medical events

 e.g., syncope, GI bleeding, severe dehydration, etc.

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*We recommend that patients are weighed in gown only, after voiding. Orthostatic vital signs are assessed by having patients lay down for 5 minutes, then measuring P&BP. Then the patient should stand, and P&BP are repeated after 2 minutes.

If you have a medically unstable patient, please call our Patient Placement team at (650) 725-8877 to discuss potential admission, 24 hours a day.Ìý

If you have any questions, feel free to contact our office atÌý(650) 723-5511 ext. 1, ext. 1 for Intake Coordinators.

For further information please seeÌýhttps://eatingdisorders.stanfordchildrens.org.

Locations
ÂÒÂ×ÉçÇø Children’s Health Specialty Services – Mountain View
ÂÒÂ×ÉçÇø Children’s Health Specialty Services – Mountain View

2495 Hospital Drive, Suite 625

Sobrato Pavilion

Mountain View, CA 94040

Maps, Directions & Parking

Phone: (650) 497-2701

El Camino Health – Mountain View Hospital
El Camino Health – Mountain View Hospital

2500 Grant Road

Mountain View, CA 94040

Maps, Directions & Parking

The Comprehensive Care Inpatient Unit

Tower C, 4th floor

Phone: (650) 723-5511

ÂÒÂ×ÉçÇø Children's Health Specialty Services – Mountain View / Castro Commons
ÂÒÂ×ÉçÇø Children's Health Specialty Services – Mountain View / Castro Commons

1174 Castro Street

Suite 250

Mountain View, CA 94040

Maps, Directions & Parking

Phone: (650) 723-5511

Psychiatry and Behavioral Science Building
Psychiatry and Behavioral Science Building

401 Quarry Road

Stanford, CA 94305

Maps, Directions & Parking

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Phone: (650) 723-5511

Document Upload

Please attach the following documents:

  • All relevant clinical documentsÌý(i.e. clinic notes, history and progress notes, medication history, growth charts-height and weight, head circumference, labs, diagnostic reports and a copy of the insurance card)
  • Please attach growth curves.

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