Patient Care / Patient Care - Lifestyle Program Self-Pay Form Lifestyle Program Self-Pay Form Contact Information First Name * the value is required must be at least 2 symbols Last Name * the value is required must be at least 2 symbols Email Address * the value is required must be a valid email address Primary Phone * the value is required must be a valid phone number Street * the value is required must be a valid street address City * the value is required must be a valid city name State * the value is required Postal Code * the value is required Services If you have any questions about payment or billing, please call us at (585) 602-0720 or email urwell.lifestyle@urmc.rochester.edu Mindfulness-Based Stress Reduction 8 Weeks & Retreat (In-Person) 6:30pm - 8:30pm, Tuesdays, May 19 - Jul 14, 2026 (No session held on 7/7/2026) $450.00 $0.00 Total: $0.00 select at least one item!
