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 the intake form within 48 hours of making your appointment.
For best results each spouse needs to fill out this form separately and as honestly.
Complete FormFor best results be as honest as you can when filling out this form.
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