HOPE AND A FUTURE
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History Form

Before scheduling an evaluation you must fill out a Application/History Form.  Please select which history form to fill out from the choices below.  The history form contains nine sections.  Complete each section to the best of your ability, and skip over any questions that are not applicable. 

History Form - Child

History Form - Adult

Our Services

The NeuroDevelopmental Approach
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Hope And A Future

Mission Statement
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Copyright ©  2008   -   801-395-1979    -   [email protected]
  • Home
  • About Us
    • Mission Statement
    • Key Personnel
  • Evaluations
    • Evaluation Procedures
    • Consultation Packages
    • Locations
    • Application Form
    • INP Review
  • Information
    • HAAF Happenings ~ Upcoming Events
    • Articles
    • Testimonies
    • Resources
  • Contact Us
  • HAAF Store
    • Store