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ALCHEMY ACADEMY
PRIVATE COACHING
FUNCATIONAL NUTRITION THERAPY
ABOUT
- OUR APPROACH
CONTACT

FUNCTIONAL NUTRITION THERAPY

Restoring Balance Through Personalized, Bio-Individual Nutrition

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EMOTIONAL INTELLIGENCE GROUP
TEENS (AGES 14-17)

Parent / Guardian Full Name *

Email*

Phone*

Child's Name *

Child's Age*

Is your child available to attend the full 8-week program beginning in January?*

Yes

No

What are you hoping your child gains from this program at this stage of development?*

I understand this is an educational, skills-based program and not psychotherapy or clinical treatment.

Preferred availability (select all that apply):*

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All Rights Reserved

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