Utah Infertility Resource Center · Free Introductory Appointment

Full Name

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First Name

Last Name

Email Address

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Verify Email

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Phone Number

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I agree to receive occasional text messages from IC (Not in regards to confidential information).

Address

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City

State/Province

ZIP/Postal Code

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Is there a specific therapist you would like to meet with?

We will do our best to match you with your request depending on scheduling and availability.

Alison Brown LCSW

Cheri Fifield CSW

Marcus Hunt MFT (virtual only)

What time(s) are you available for therapy?

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check all that apply

Morning (9 am to 12 pm)

Afternoon (12 pm to 5 pm)

Evening (5 pm to 8 pm)

Prior to your appointment is there anything that you would like us to know?

Were you referred to us by a fertility clinic or other provider?

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Including but not limited to acupuncturists, physical therapists, OBGYN, etc.

Please let us know which provider referred you:

How did you hear about us?

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Facebook

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Friend/Word of Mouth

News Article

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