Common Contracts
1 similar Agreement for Payment and Financial Responsibilities contracts
AGREEMENT FOR PAYMENT AND FINANCIAL RESPONSIBILITIESAgreement for Payment and Financial Responsibilities • August 14th, 2020
Gloria Dove works with a mission to improve emotional, and relational well-being through quality and affordable counseling, professional training, and community education. The standard fee for a first evaluation appointment is $175 and the standard fee for ongoing counseling is $125 per 60-minute session. We also have sliding scale for those whose income cannot support the standard fee. Annually we review fees and renew the agreement for payment. There is a cost of living increase typically 1-2% each year. Please complete the following and return to your counselor.
