Request for Integrative Services
Integrative services are offered to trauma survivors throughout Nevada, the Route 91 community, emergency responders in Clark County, and anyone impacted by any mass violence incident nationwide. To request authorization to participate, please complete the following:  
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Name(s): *
Best way to contact: *
Please provide email address, phone number, or other contact info.
Service(s) requested: *
†must be used in conjunction with (or as a follow-up to) other evidence-based treatment
Required
Description of goal or purpose of service(s): *
Please check all that apply:
(optional)
If a therapist or someone else recommended you, please let us know who:
(optional)
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