LW Teens Consent Form

**All Fields Required**
arrow&v

By filling out and submitting this form, you consent that you are 14-18 years old and that LiveWell provides facilitators and educators, not mental health professionals. By attending this online group, you understand it is a peer-to-peer support group, and not intended as clinical or medical services.

 

Upon clicking SUBMIT below, you will be re-directed to join a LiveWell Teens Support Group hosted by Zoom. 

 

The LiveWell Foundation does not share your data with any third party company or organization.

Please save your info on your browser, as you will need to fill out this form for each meeting you wish to attend. Thanks!

If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) 

or contact the Crisis Text Line by texting TALK to 741741.  

 

The LiveWell Foundation & LiveWell Teens do not provide emergency services. 

  • Facebook - White Circle
  • Instagram - White Circle
  • Snapchat - White Circle

267.530.3739  

contact@livewell-foundation.org

250 South 17th Street, 1400

Philadelphia, PA 19103

Help us KEEP IT FREE to the community

by making a tax-deductible donation today!

PA EIN #81-4711726