Thank you for scheduling your appointment! To help us prepare for your session and provide you with the best possible experience, please complete the appropriate intake form below.
Important: Please complete your intake form at least 24 hours before your scheduled appointment.
For clients scheduled for Brain Integration Technique (BIT) sessions to address learning disabilities like ADHD, Dyslexia, and APD.
Complete FormFor clients scheduled for Brain Coding sessions to address root causes of physical, emotional, and mental health challenges.
Complete FormFor clients scheduled for Personal Development and Self-Improvement coaching sessions.
Complete FormMost intake forms take 10-15 minutes to complete. Please set aside enough time to thoughtfully answer all questions.
All information you provide is confidential and protected. We take your privacy seriously and comply with all HIPAA regulations.
If you have questions about which form to complete or need assistance, please contact us at trevor@utahbrainintegration.com
You can save your progress and return to complete the form later if needed. Your information will be securely stored.
If you've enrolled in one of our DIY online sessions or courses, you can access them through our Learning Management System.