If your child is experiencing

  • Poor grades/School failure
  • Lack of motivation
  • Low self esteem
  • ADD-ADHD-ODD
  • Depression/Anxiety
  • Weight loss/gain
  • Defiance/Anger
  • Drug or Alcohol abuse
  • Change of friends/Negative peer group
  • Family discord
  • Withdrawal from family
  • Mood swings
  • Sexual promiscuity
  • Self Abuse
  • Struggling teen
  • Suicidal tendencies

We can help.

Contact us now at:
801.473.6606

Feel free to fill in the form below as much or as little as you like.

To get help now for your struggling teen, fill in the form as much as you would like and click SEND, call our number at 801.473.6606, or e-mail us at info@teen180.com.

Once we receive your child’s information, we’ll call you for a no obligation consultation and help you understand the options for turning around your struggling teen—we'll walk you through what you need to know to get the right help for your child.

The information you provide us is secure and will be shared with professionals and treatment programs only if appropriate and only after receiving your consent. Your information will be used in no way other than to obtain the proper support and treatment for your child, and then only after your consent.

 
 
Child’s First Name:
Child’s Last Name
Child’s Gender
Child’s Age
Child’s Birth Date (mm/dd/yyyy)
Last Year in School Completed
Current Year in School
Your Name
State
Home Phone Click if preferred
Work Phone Click if preferred
Cell Phone Click if preferred
Your Time Zone
Best time to call you
Your E-mail Address
Re-enter Your E-mail Address
Check issues that apply to your child
  Defiant
Underachiever
Suspended from School
Lack of Motivation
ADD/ADHD
Learning Issues/LD
Oppositional/ODD
Expulsion from School
Truancy
Depression
Adoption Issues/RAD
Entitlement Issues
Drug or Alcohol Usage
Sexually Active
Undesirable Peers
Gang Involvement
Suicidal or Thoughts of Suicide
Violent, Anger, Rage, Rebellious
Withdrawn
Disrespects Authority
Additional Comments or Issues
 

Helpline

  • Troubled teen?
  • Need answers?
  • We can Help.
  • Call us for a consultation

801.473.6606

Teen Assessment

If you would like to speak with
one of our counselors with no
obligation, please fill in the
Teen Assessment Form below.

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