Trauma Awareness & Treatment Center TATC

Intake and Self-Assessments
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If you feel that our services would be beneficial to you, feel free to fill out our intake forms and assessment tools to begin the intake process. The forms are listed below along with a brief description.

Initial Intake Form:

Use this form to fill out demographic information and bring it to your first appointment. Download it in MS Word doc. format to fill out in the privacy of your home.

click here to download file

Our Assessment provides you the ability to indicate the feelings and symptoms that you are experiencing. Feel free to download it in an MS Word doc format and complete in the privacy of your own home. Bring it to your first appointment along with the Initial Intake forms.

click here to download file

Stress Symptoms Checklist

Stressor Questionnaire

PTSD Scale

Adult Dissociation Scale

Adolescent Dissociation Scale

Child Dissociative Checklist

Interpreting The Child and Adolescent CDC

Interpreting the DES

If you would like to talk to a TATC staff member regarding the intake or assessment(s) you completed, please submit a comment using the form below along with an email address or phone number. Include the nature of your inquiry and when we can contact you.

Full name:
Email address:
Comments:
 

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Trauma Awareness & Treatment Center TATC
32 West Winchester Street, Suite 101
Murray, UT  84107 

Ph. (801) 263-6367      Fax (801) 263-6370 

E-Mail
TraumaAwareness@Yahoo.com

www.TraumaAwareness.Org
 

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