Healing into Life
Please fill out this form before your first appointment.
This form can be filled out and e-mailed to firstname.lastname@example.org or it can be printed and turned in at your first appointment.
Appointment times have been arranged specifically for you. If you arrive late your session may be shortened in order to accommodate others whose appointments follow yours. Depending upon how late you arrive, your therapist will determine if there is enough time remaining to start a treatment. Regardless of the length of the treatment actually given, you will be responsible for the full session.
We understand that unanticipated events happen occasionally in everyone’s life. Business meetings, project deadlines, flight delays, car problems, snowstorms, and illness are just a few reasons why one might consider canceling an appointment. In our desire to be effective and fair to all of our clients, and out of consideration for our therapists’ time, we have adopted the following policies:
24 hour notice is required when cancelling an appointment. This allows the opportunity for someone else to schedule an appointment.
If you are unable to give us 24 hours advance notice you will be charged the full amount of your appointment. This amount must be paid prior to your next scheduled appointment.
Anyone who either forgets or consciously chooses to forgo their appointment for whatever reason will be considered a “no-show”. They will be charged for their missed appointment and future service will be denied until payment is made.