Hope Springs Counseling, PLLC

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I understand and agree to the following:

Payment method(s) provided may be used to charge any current or future amounts owed, without additional pre-approval or notification. Payment is due at each session, and the full appointment fee may be due for no-shows or cancelling less than 24 hours in advance.

In the case of a missed session / cancellation, charges may be made against any payment method(s) provided. If alternate payment arrangements need to be made, advance notice must be provided.

If making payment via debit card or bank account, and there are insufficient funds in the associated account, a fee of $20 may apply if the charge is not honored, and overdraft charges and/or fees from the relevant financial institution may be incurred. Fees may also apply if the credit limit of a credit card I supply is exceeded.