About
Services
Team
Financial Info
Classes
Contact Us
Request Appointment
Client Payment Portal
We also provide
adoption services
About
Services
Team
Financial Info
Classes
Contact Us
Request Appointment
Client Payment Portal
Appointments
Please fill out the form to request an appointment.
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Age of Client (years)
(Required)
Please enter a number less than or equal to
120
.
Insurance Provider (if self pay, please state)
(Required)
We are paneled with BCBS, DMBA, EMI Health, PEHP, Select Health and United Healthcare
Location
(Required)
Holladay Office
Bluffdale Office
Pleasant Grove Office
Was there a specific therapist you were referred to?
(Required)
List of therapists on team page
Virtual or In Person?
(Required)
In Person
Virtual
What days work best for you?
(Required)
Monday
Tuesday
Wednesday
Thursday
Friday
What time works best for you?
(Required)
Morning
Afternoon
Evening
Please explain why you are seeking an appointment?
(Required)
I would like to be notified about various classes/workshops that Millcreek Counseling offers . Please note that we do not rent or sell your information to any third parties!
(Required)
Yes
No
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