Youth Mental Health First Aid October 2023 Registration Form

Cohen Clinic Youth Task Force Sign-Up Form

Please fill out the form below and the facilitators will contact you shortly!
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Where did you hear about the Cohen Clinic Youth Task Force?
What other types of events or workshops would you be interested in?
To find out more about the groups, events and workshops offered by the Cohen Clinic at Centerstone, or to sign up for our newsletter, please visit:

coheninthecommunity.com
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Cohen Clinic Youth Task Force Sign-Up Form