Thank you for coming to see me! I hope that I can provide you with a meaningful and effective source of support as we work together to make life better for you and/or your family. There are several forms on this page that I would like you to print out, complete, and bring with you to your first appointment; if printing these forms is inconvenient for you, paper copies are available at Mt. Logan Clinic during regular business hours. If you have any questions at any time, please do not hesitate to contact the receptionist at Mt. Logan Clinic, or me; we will do our best to give you whatever information you need. We can be reached at (435) 750-6300, Monday through Thursday, 9 a.m. – 5 p.m.
Please complete the applicable form for each person who is coming in:
- If you are an adult coming in for yourself, please complete the adult new patient packet. If you are coming in as a couple, I would like each person to complete the adult intake form (contained in the adult new patient packet) independent of each other, please.
- If your adolescent child is coming, please complete the adolescent new patient packet. Please note that the adolescent should complete the adolescent intake form and parent(s)/caregiver(s) should complete child intake form.
- If your child is coming, I would prefer that parent(s)/caregiver(s) complete the child new patient packet, please.
- For all patients who have been working with me and have not yet done so, please complete these updated forms.