Our admissions process begins when you fill out our Request for Information form below, or when you call our Admissions Department directly with inquiries.

We accept referrals for students with various special needs, learning disorders, and/or specific diagnoses (see Admissions Criteria.). An application may be made at any time and students may enter the program at various times throughout the year.

Admission acceptance is based upon academic and psychological assessments, previous school history and available openings. Decision for placement is usually made within a few days, and is finalized after completion of an interview and review of materials.

An on-site pre-placement interview provides a good opportunity for you to tour the campus and for all parties to assess the appropriateness of placement at Uta Halee Girls Village or Cooper Village.

If you have questions and wish to speak to our Admissions Department please call.

Uta Halee Girls Village Admissions
Pegg Siemek-Asche, Admissions Therapist & Supervisor
Phone: (402) 457-1325
psiemek-asche@utahalee-cooper.org

Uta Halee Girls Village
10625 Calhoun Road
Omaha, NE 68112
Phone: (402) 457-1300
Fax: (402) 457-1403

Uta Halee and Cooper Village Corporate Office
3017 Mormon Street
Omaha, NE 68112
Phone: (402) 457-1300
Fax: (402) 453-8923

Request for Information

Please take a moment to fill out this form as completely as possible. This will give us important information about the potential student and help us expedite the admissions process. Thank you.

 

I am a:	parent/guardian educator or professional
First Name:
Last Name:
Title:
Organization:
Street address:
Address (cont.):
City:
State Province:
Zip/Postal code:
Country:
Work Phone:
Fax:
E-mail:

Information about the potential student:

Student First name:
Last name:
Date of Birth:
Sex:	Male Female
Medical diagnosis:
Present academic placement:
Grade:		Public School Private School
Previous psychiatric hospitalization?	Yes No

Use the space below for other comments or questions:

How did you learn about Uta Halee Girls Village and Cooper Village? (Please list reference - ex: Google or Yahoo internet search on ADHD, bi-polar, etc.)

Thank you
for your interest in  Uta Halee Girls Village and Cooper Village.

Only click once ... The information will be sent to us by Email.

---

In addition , our Admissions Therapist will request the following information at the time of application (if available):

• Psychiatric Evaluation
• Psychological Evaluation (including IQ score)
• Admission and Discharge Summaries from previous treatment facilities and hospitalizations if applicable
• Psychosocial History
• School records and immunization forms
• Copy of birth certificate
• Copy of social security card
• Date of last physical exam