Enlighten Nutrition 8 Week Teen Support Group 
Enlighten is now offering a 8 Week teen virtual support group that will take a deeper look at disordered eating and provide an open and safe space to further the journey towards a positive relationship with food, body, and mind.  

The group will be held virtually and will have a unique link that will be sent via email once your registration and payment has been received.  Each group is $25 per session or $175 for all 8 weeks. 

At this time, Enlighten will not be able to bill insurance for this service. We strive on providing affordable care, if at any point you feel that this is not possible for you please contact our office and will work with you the best we can
Email *
Participant Full Name (First, Middle, Last)  *
Participant Date of Birth  *
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Participant Email Address  *
Participant Phone Number  *
Parent/Guardian Name (First and Last) 
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Parent/Guardian Email Address
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Parent/Guardian Phone Number
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If you/your child currently have a treatment team, please provide information below. 
Which weeks would you like to attend? ($25/per group) *
Required
If you selected all 8 weeks and would like to pay $175 for all 8 vs. each group week by week at the rate of $25 per group, please select yes. 
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I acknowledge that this group is a supplemental group and does not replace eating disorder care. This group is a 100% virtually run group, and does not provide medical nutrition therapy. 

I acknowledge that insurance will not cover such services and I am financially responsible to the fee of the group. 

I acknowledge that Enlighten Nutrition, Counseling and Care, LLC is offering this group in an outpatient setting and is not liable for individual care. 


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