Skip to content

  • Contact
  • Donate

Primary Menu

  • About
    • Our Mission
    • Board of Directors
    • National Advisory Board
    • CCPC Annual Report
    • Staff
    • Community Partners
    • Media Appearances
    • Hours & Locations
    • Contact Us
  • Programs
    • CCPC Programs
    • Food Assistance Programs
    • Food Pantries
    • Meeting Basic Needs
    • Local Outreach
    • Seasonal Worker Outreach
    • Native American Outreach
  • Events
    • Event Calendar
    • Back 2 School Basics
    • Hike for Hunger
    • Operation Hope
    • Community News & Events
    • Event Space Rentals
  • Mental Health
    • Our Team
    • Counseling & Wellness Services
    • Neurofeedback
    • Marriage Intensive
    • Interest Form
    • Billing
    • Counseling Center Events
    • Resources
    • Counseling Blog
  • Get Involved
    • Donate Financially
    • Volunteer
    • Job Openings
    • Join Our Mailing List
  • Stores
    • Our Stores
    • Park City Boutique
    • Park City Thrift
    • Summit Exchange
    • Heber Valley Thrift
  • Donate Items
    • Drop Off Information
    • Schedule a Pickup

Counseling & Wellness Interest Form

Please fill out the form below with your interest and a CCPC Counseling and Wellness representative will be in touch with you shortly. Please match your insurance provider with a corresponding clinician who you feel can best meet your needs.

Client Name(Required)
Which location are you most interested in? Check all that apply.(Required)
Do you have an insurance provider?(Required)
Please select your insurance provider.(Required)
If your insurance provider is not listed below, we currently do not accept your insurance plan. Private pay and financial assistance may be available.
SelectHealth Providers - Please select your top clinician preference that is in network with your primary insurance.(Required)
BCBS Providers - Please select your top clinician preference that is in network with your primary insurance.(Required)
University of Utah Health - Please select your top clinician preference that is in network with your primary insurance.(Required)
EMI Health - Please select your top clinician preference that is in network with your primary insurance.(Required)
PEHP - Please select your top clinician preference that is in network with your primary insurance.(Required)
Blomquist Hale - Please select your top clinician preference that is in network with your primary insurance.(Required)
United Health Care - Please select your top clinician preference that is in network with your primary insurance.(Required)
UMR - Please select your top clinician preference that is in network with your primary insurance.(Required)
Imagine Health - Please select your top clinician preference that is in network with your primary insurance.(Required)
Aetna - Please select your top clinician preference that is in network with your primary insurance.(Required)
TriCare - Please select your top clinician preference that is in network with your primary insurance.(Required)
UNI - Behavioral Health Network, HMHI-BHN - Please select your top clinician preference that is in network with your primary insurance.(Required)
MINES & Associates - Please select your top clinician preference that is in network with your primary insurance.(Required)
Top Clinician Preference
Private Pay(Required)
Private pay is for patients with no health insurance or a plan CCPC does not currently accept.
Do you need financial assistance?(Required)
Primary Insured Date of Birth(Required)

Park City Campus 1283 Deer Valley Drive Park City, Utah 84060 (435) 649-2260
Heber Valley Campus 55 East Center Street Heber City, Utah 84032
Junction Commons 6699 Landmark Drive Suite K160 Park City, Utah 94098
Mailing Address PO Box 683480 Park City, Utah 84068

Hours and Contact Donate

Who We Are

  • Board of Directors
  • National Advisory Board
  • Staff
  • Job Openings
  • Financial Accountability
  • 4-Star Charity Navigator Charity

Resources

  • Community Social Services
  • Local Job Openings
  • Mental Health Services
  • Community Resources
  • Local Faith Communities

Get Involved

  • Donate Financially
  • Donate Items
  • Volunteer
  • Join Our Mailing List

News & Events

  • Event Calendar
  • Nonprofit Leadership Podcast
  • Annual Newsletters
  • Annual Report
  • vimeo
© 2025 Christian Center of Park City. All Rights Reserved.
Terms of Use | Privacy Policy | Website User and Application Agreement