Request To Join Support Group or Program
Thank you for your interest in Cheers To Life Counseling (CTLC)! Please complete the questions below and you will be contacted BY EMAIL as soon as possible for next steps.

*Please note that CTLC does not prescribe medication and only provides support and coaching related to feelings of Anxiety, Depression and some Trauma.
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Email *
Your Full Name *
If registering a minor, please add their Full Name below: *
Participants Birthdate *
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Phone Number *
Is it ok to leave a message at this number? *
Is it ok to text this number? *
Which support group or program are you. interested in? *
Required
Please provide a short description of why you are interested in the support group or program? *
How did you hear about cheers to life counseling? *
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LeadHER Circle Flyer
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