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If you are in crisis and need to talk to someone immediately, please call our toll-free confidential hotline at 1 800 821-HELP (4357) or click here to speak with a counselor online.

Contact Information

Full Name: *

(first, middle, last name)

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What type of treatment are you looking for?
Drug and/or Alcohol Detox
Drug and/or Alcohol Rehab
Drug and/or Alcohol Day Treatment
Psychiatric Inpatient Treatment
Psychiatric Day Treatment

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How may we help you?

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Need assistance with this form?

Please be aware if you are seeking specific information or have questions about your own treatment or the treatment of another individual, you will need to call Highland Ridge Hospital directly at (801) 569-2153. (We cannot respond to confidential patient-specific inquiries via this Internet form). Please keep in mind that confidentiality laws prohibit us from discussing with you any patient’s information without the patient’s prior express written authorization. If you are in crisis and need to talk to someone immediately, please call our toll-free confidential hotline at 1-800-821-HELP (4374).