Admissions Information / Referrals
Thank you for your interest in Youth Home, Inc. We know that seeking residential treatment can be a difficult decision to make. We are dedicated to providing your child and family with the best quality of care. Youth Home serves beneficiaries of all Provider-Led Arkansas Shared Savings Entities (PASSE). We also proudly accept TRICARE®.
Below are links to our admissions form and other important information we will need based on your insurance. Reach out to us with any questions or if you are unable to complete these forms online and need copies mailed or faxed. Please call our admissions team before completing any information if you have insurance other than TRICARE or Arkansas Medicaid.
For those who do not have TRICARE® or an ARKANSAS PASSE, or if you have any questions or concerns, please contact us for additional information.
Admissions Department
Phone: (501) 821-5500 or 1-800-728-6452
Fax: (501) 821-5582 or (501) 821-5580
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Thank you again for your consideration of Youth Home, Inc.
*Form created by Youth Home, Inc. using Cognito Forms secure, HIPAA compliant inbox service
**Form created by Health Net