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Registration - IMPORTANT

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After you register, check your email for our "Welcome Letter" which includes a code for you to use in our "MEMBER'S ONLY"  area located on every page. 

 

PayPal Checkout

No account required

Consent & Release Form

CONSENT TO RELEASE CONFIDENTIAL INFORMATION

By filling out and signing this form, I (the under signed) give my rep at Cornerstone Recovery Coaching permission to submit all needed info to the person and/or agency I have referenced below. I understand that this Release Form is valid from one year from the date signed.

Your Date of Birth:
Today's Date

Accreditations and Affiliations

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