Important Notice Regarding Covid-19 outbreak
Home
Programs
Detox
Residential Treatment
Day Treatment
IOP (intensive outpatient program)
Sober living
Treatment Center
DBT (Dialectical Behavioral Therapy)
EMDR (Eye Movement Desensitization and Reprocessing)
Substance Abuse 12 Steps
CBT(Cognitive behavioral therapy)
RPT (Physical Exercise and Recreational Therapy)
Mindfulness
Seeking Safety
Gender-Specific Trauma Care
Equine Therapy
Recreational Therapy
Locations
Salt Lake County
St. George
Utah County
Admissions
About
Our Staff
Blog
Contact Us
Menu
Home
Programs
Detox
Residential Treatment
Day Treatment
IOP (intensive outpatient program)
Sober living
Treatment Center
DBT (Dialectical Behavioral Therapy)
EMDR (Eye Movement Desensitization and Reprocessing)
Substance Abuse 12 Steps
CBT(Cognitive behavioral therapy)
RPT (Physical Exercise and Recreational Therapy)
Mindfulness
Seeking Safety
Gender-Specific Trauma Care
Equine Therapy
Recreational Therapy
Locations
Salt Lake County
St. George
Utah County
Admissions
About
Our Staff
Blog
Contact Us
24 Hour Hotline
801-800-8142
Instagram
Facebook
Twitter
Youtube
Linkedin-in
Step
1
of
2
- Patient Information
0%
Hidden
FormId
Patient Information
Primary Contact First Name
(Required)
Primary Contact Last Name
Primary Contact Email
(Required)
Primary Contact Phone
(Required)
Patient First Name
(Required)
Patient Last Name
(Required)
Patient Date of Birth
(Required)
MM slash DD slash YYYY
INSURANCE COMPANY INFORMATION
Insurance Company Name
(Required)
Member ID
(Required)
Patient Address
Street Address
Address Line 2
City
ZIP / Postal Code
Interested In
(Required)
