285 W. 800 S.
Roosevelt, Utah 84066

(435) 725-6300
1140 W. 500 S.
Vernal, Utah 84078

(435) 789-6300


info@nccutah.org
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~ Paperwork required for Services ~


Please print and complete the coresponding paperwork for your initial counseling session. The completed forms will be required at your first counseling session. If you have any question about these forms please contact one of our offices for more information.


You are seeking assistance for substance use, Alcohol use or a DUI.
Complete the following packet of information.    PDF File Client Substance use information packet


You are UNDER 18 and seeking services for depression ,anxiety, suicide related, or for other mental health issues.
Complete the following packet of information.    PDF File Youth Mental Health information packet


You are OVER 18 and seeking services for depression ,anxiety, suicide related, or for other mental health issues.
Complete the following packet of information.    PDF File Adult Mental Health information packet





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