Welcome to The REI Custom Calm Program

Online Intake Form

Please complete and submit the intake. We will place Track #1 of your REI Custom Program into your account within 24 hours.

Call us at 800-659-6644 or email us at [email protected] with any questions. 

Instructions

Please select a rating for each of the following questions. Refer to behavior for the past 3 months. For each item, decide whether the behavior is relevant and to what degree.

• Not relevant = You never see this behavior
• Slightly relevant = You rarely see this behavior
• Pretty relevant = You ocassionally see this behavior
• Very relevant = You often see this behavior

Remember: Don't think too hard about the answer -- your first reaction is usually the right one.