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Road to Healing Counseling

Road to Healing Counseling

Trauma Treatment is a Journey to Reclaim Your Story

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Client Intake Forms

Please review and complete these forms prior to your initial visit.

Adult Intake Interview

Child/Adolescent Intake Interview

Release of Protected Health Information

Consent for Care Agreement

Custody/Access Dispute Contract

Financial Agreement

HIPAA Notice of Privacy Practices

Telehealth Informed Consent

Social Media Policy

Road to Healing Counseling

1345 E 3900 S, Ste 104

Millcreek, UT 84124

(801) 441-8943

[email protected]

DOPL #6291992-2501

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In crisis? Call or text 988 (Suicide & Crisis Lifeline), or call 911 in an emergency. This practice cannot respond to emergencies

  • About
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  • Blog
  • Forms
  • Fees & Policies
  • Frequently Asked Questions
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