Ridley-Tree Cancer Center

Wellness Program Registration

Ridley-Tree Cancer Center offers Wellness Classes free-of-charge to cancer patients who are in active treatment under the care of an oncologist and for 1 year after treatment is completed. Classes are also offered to caregivers during this period of time. In addition, several classes are available to survivors who are beyond 1 year post-treatment.


Ridley-Tree Cancer Center aspires to provide a safe, healing space for those in the midst of a difficult time. Participants are asked to respect and support the program guidelines. We reserve the right to deny anyone admittance.


If you have questions about our program or your eligibility, please contact Youngmi An, Wellness Program Manager at (805) 879-5678 or youngmi.an@sutterhealth.org.

 

Please check the appropriate box: (Required)

 
 
 

 
 
 
 
mm/dd/yyyy
 
Phone
 
 
 

If you are a caregiver, enter N/A.

 

If you are a caregiver, enter the month and year of the patient's diagnosis.

 

If you are a caregiver, enter the patient's oncologist.

 

Check all that apply

 

Check all that apply

 

Waiver

I have voluntarily chosen to take part in wellness activities offered by the Ridley-Tree Cancer Center. I understand that some activities may expose me to hazards or risks that could result in my injury and I understand and appreciate the nature of such risks and hazards. I wish to take part in these activities, and I accept the risk and hazards that may result from such participation. Since participation is based on mutual consent, I understand that the right to terminate participation can be made by me or the Wellness Program Parties at will, with or without cause, at any time.


I hereby release the Ridley-Tree Cancer Center at Sutter Health, Sutter Health, Sansum Clinic, and the Cancer Foundation of Santa Barbara, and all of their directors, officers, agents, employees, program facilitators/instructors, volunteers, and participating agencies (collectively the “Wellness Program Parties”) from any and all liability arising out of or connected in any way with my participation in any activities offered at the Ridley-Tree Cancer Center, including those arising from or contributing to any physical impairment or defect I may have, whether latent or patent. I also understand and agree that this release is binding upon my heirs and assigns. I agree that the Wellness Program Parties are under no obligation to provide physical examination or other evidence of my fitness or ability to participate in this activity, this being my sole responsibility. I certify that there are no health-related reasons or problems which preclude my participation in the wellness activities and I have not been advised to not participate in such activities by a qualified medical professional.

 

Enter your full name

 
 
mm/dd/yyyy
 

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