Healing With Peers

A support group for Tweens and Teens (Ages 10-17)

Program is FREE for those under 18.

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Mondays: 3:30-5:00
Oct 5, 12, 19 and 26
Nov 2 and 9

Tuesdays: 4:30-6:00
Oct 6, 13, 20 and 27
Nov 3 and 10

The Stephan Center
815 W 6th St Suite 145 Corona Ca 92881

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Parent Name(Required)

First Last

Youth Name(Required)

First Last

Age Group(Required)

Ages 10-12yrs

Ages 13-17yrs

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Email Address(Required)

Age of Youth(Required)

School Year of Youth(Required)

Youth or Family Member Loss(Required)

Number of Siblings/Youth in your home(Required)