CLIENT FORMS
For your convenience, we have made our forms available for our clients. We encourage you to fill out
these forms in advance of your first visit. This will help minimize the time you spend in the waiting room and allow you to have more time with your therapist. All forms completed online are secure and confidential.

If you have any questions regarding your paperwork, please call (801) 984-1717 for assistance.
You may also visit Frequently Asked Questions.

Ages 12+
*Legal guardian signature required
on intake forms.
Ages 11 and Under
*Legal guardian signature required
on intake forms.
If you need to release any information regarding your treatment at Life Stone,
you will need to complete this form.
*Required by all yoga class participants.

*Required before all medical visits with a prescribing clinician.

*Please be sure to include on the release (pg 2)  information for anyone you would like your treatment shared with(i.e. court, attorney).





SALT LAKE COUNTY
613 E. Ft Union Blvd #104
Midvale, UT 84047
Phone: (801) 984-1717
Fax: (801) 984-1720
UTAH COUNTY
150 S. 400 E.
American Fork, UT 84003
Phone: (801) 980-7222
Fax: (801) 980-7223
© 2018 Life Stone Group, LLC All Rights Reserved. 
Insurance Billing Dept:
(801) 296-2113

Mailing Address:
613 E. Ft Union Blvd #104
Midvale, UT 84047