$50 Sessions

Name *

First Name

Last Name

Phone

(###)

###

####

Are you a Weber County Resident? *

Yes

No

Another option is to take advantage of your insurance. If you'd like to, select yours below:

PEHP

Blue Cross Blue Shield

AETNA

Health EZ

University of Utah (Healthy Premier/Preferred)

Select Health (Care, Choice, Value, Med, Signature, Share)

Out-of-network plan: DMBA

None of the above

Uninsured