top of page
CSC-CWA Web Banner RED.png

New Client Form

CLIENT

Birthdate
Month
Day
Year
Gender
Primary Language(s)
Race/Ethnicity

CONTACT INFORMATION

Preferred Contact Method(s)

CONTACT US​

Pacific Professional Building

610 N Mission Street #202

Wenatchee, WA 98801

509.888.9933

FOLLOW US

STAY IN THE KNOW

Join Our Group

Cancer Support Community Central Washington is a program of Wellness Place, a 501(c)(3) nonprofit organization: EIN: 91-1891688

© 2026 Cancer Support Community Central Washington. All rights reserved.

bottom of page