Hennepin Healthcare Outpatient Mental Health Programs
Thank you for your interest in the intensive outpatient mental health programs at Hennepin Health.
IMPORTANT: This service is not intended for emergencies. If you are experiencing an emergency, please call 911 or go to the nearest Emergency Department. For urgent mental health support, you can also call the 988 Suicide & Crisis Lifeline.
When we receive your referral, we will contact you to schedule an intake. All patients are required to complete an intake to determine if the program is the best fit for you at this time.
The Partial Hospital Program
is a comprehensive full-day program of services that also includes psychiatric medication evaluation and management services. This program runs Monday through Friday and daily attendance is expected for the roughly three-week duration of the program. The program hours are 9:00 am – 3:00 pm.
The Day Treatment Program
offers a variety of services designed to restore or increase functioning for patients who are struggling with mental health disorders. Depending on the track, patients attend either 3 or 4 days per week for 3 hours. Programming is offered in the morning as well as the afternoon. Length of stay varies based on track and/or patient need. Patients typically attend Day Treatment for 2-4 months.
If you have any questions about either program, please call:
Partial Hospital Program Phone number:
612-873-2212
Day Treatment Program phone number:
612-873-4304
Required
Patient Information:
Patient Name (including preferred name):
Preferred Pronouns:
Date of birth
Primary Language:
Mailing Address:
City:
State:
Zip Code:
Current patient location
if not living at the address above
:
Best phone number to reach you:
Alternative Phone Number (if any):
Email address:
Primary Insurance and ID:
Secondary Insurance and ID:
Reason for Referral:
Why are you interested in attending a program at this time?
What mental health symptoms/struggles are you experiencing?
Please share any recent traumas or significant changes in your life that may be contributing to why you need this level of care:
How did you hear about our programs?
Are there other providers you are working with?
Yes
No
If you answered yes, please complete the following information:
Psychiatrist or advanced-practice psychiatric provider:
Clinic Name:
Clinic Phone Number:
Psychologist or therapist:
Clinic Name:
Phone Number:
Case Manager:
Clinic Name:
Phone Number:
Other Provider:
Clinic Name:
Phone Number:
What (if any) other services do you currently receive?
Have you attended either of these programs before?
Yes
No
Do you have a 1:1 in your living facility?
Yes
No
Do you need help with mobility or assistance with transfers?
Yes
No
Are you able to sit for up to an hour and attend the program daily for either 3 or 5 hours depending on the program?
Yes
No
Do you require a language interpreter?
Yes
No
Optional Questions:
Did someone refer you to this program or recommend you contact us?
Yes (If yes, please complete the following referral source)
No
Referral Source
Referral Name (optional)
Referral Phone (optional)
Referral Email Address (optional)
Submit Form