Community Wellness Center Program Request

We are delighted to host groups focused on enhancing the wellness of our community of staff, patients, their families, and our neighbors. Please check our calendar of currently scheduled events to see if there are dates available for your program.
In order to ensure that the Community Wellness Center provides programs in a way that is consistent with our mission, we request that you provide the following information:
Name * Email * Phone*
Activity/Program Title*
Activity Program Description

Facilitator/Speaker Name(s)*
Presenter Bio(s)

Duration* One Day EventSeries
Start Date* - Month Date Year
End Date* - Month Date Year
Day(s)* MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Start Time: : End Time: :
Anticipated Number of Participants*
Registration Drop-in GroupPre-Registration Required
Registration Eligibility Requirements

Audio/Visual/Equipment Needs

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