Forms

The following forms are required for all new clients in our office.

Adult Intake Form-New client.pdf
Adobe Acrobat document [431.6 KB]
Child Intake.pdf
Adobe Acrobat document [312.9 KB]
ACCOUNT INFORMATION.pdf
Adobe Acrobat document [176.7 KB]
Client Agreement and Therapeutic Policie[...]
Adobe Acrobat document [305.8 KB]
CONSENT FOR TREATMENT OF A MINOR CHILD.p[...]
Adobe Acrobat document [366.2 KB]
Release of Private Health Information.pd[...]
Adobe Acrobat document [177.7 KB]

Contact Us

Address

Successful Therapy
526 W Center Street

Suite S-107

Pleasant Grove, UT

84062

 

Phone: 801 787 7735

 

Email:

successfultherapy@gmail.com

 

Or use our contact form.

Latest News

We are happy to announce we have moved to a new location!!  We look forward to serving our clients in this new wonderful setting.

 

 

We are also pleased to announce that we now accept VENMO.  If you would like to use Venmo to pay for your appointments our venmo account is

@Successful-Therapy 

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