Small Group Registration
Thank you for your interest in a psycho-educational group. Please complete this form and submit. Healing Hearts, LLC will reach out to verify insurance and confirm next steps.

Worry Warriors (ages 7-10): Mondays, 5:00-5:45pm, November 6 - December 18
  • We will learn what worry is and how it affects the body. We'll learn and practice strategies for dealing with worries in the moment.
Self-Confidence (ages 8-11): Mondays, 6:00-6:45pm, November 6 - December 18
  • We will learn and practice valuable confidence and self-love skills.
Resiliency & Coping (ages 9-12): Mondays, 7:00-7:45pm, November 6 - December 18
  • Growing up can be hard. We'll learn strategies to manage emotions and build resiliency to help weather the storm.

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Email *
Child's Name: *
Child's Age
 *
Child's Date of Birth:  *
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Parent/Guardian Name: *
Parent/Guardian Contact Number: *
I am registering my child for the following group (choose one): *
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Please select if you be using insurance or self-pay
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Name of insurance company (if you plan on using insurance)
** You may reach out to Healing Hearts at 717-969-8894 to verify insurance **
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