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Registration request for Healthy YOU (4-part series)


Thank you for your interest in this event/program. Please complete and submit the form below.


Timeslot:
Monday 1st Feb 2027, 6:00pm - 7:30pm
Location:
Rockwood Clinic
Unit A, 175 Alma Street, Box 340 Rockwood ON Click here for map
Availability:
100 spaces remaining



Full Legal Name:
 
Date of Birth:
Email:
Confirm email:
 
Phone Number:
 
Are you enrolled with one of our physicians?
I would prefer to attend virtually (Zoom):
I would prefer to attend In Person:
How did you hear about this program?
Message:
 
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