Court Order Registration – Live Life Wellness Clinic LLC

Court Order Classes Registration

Use the following form to register for court order classes. All fields are mandatory to be filled.

Full Name

Phone

Gender

Date of Birth

Street Address

City

State

Zip

Class Selection

Number of Classes Ordered By Court

Reasons For Registration

Court Case Number

Court Name or Probation Dept

Court State

Next Court Date

Is There A Victim Named In This Case

Driver License/ID #

Acceptance

By submitting the form, I agree to the terms and conditions and privacy policy.

Live Life Wellness Clinic is a trusted provider of behavioral health and mental health care and community resource assistance. We also offer court-ordered classes to support individuals in their journey towards healing, personal growth and life recovery.

Court Order Classes Registration

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