Client RegistrationClient Registration and Financial Agreement • September 9th, 2021
Contract Type FiledSeptember 9th, 2021Email Address: Date of Birth: Sex/Gender: Home Phone: Cell: Client’s Spouse/Partner (if applicable): (If Client is a Student) Name of School: Grade:
FINANCIAL AGREEMENTClient Registration and Financial Agreement • September 12th, 2018
Contract Type FiledSeptember 12th, 2018
Client Registration and Financial AgreementClient Registration and Financial Agreement • December 26th, 2017
Contract Type FiledDecember 26th, 2017With the exception of emergencies, a minimum of 24 hours’ notice is required for cancellation of appointments to avoid being responsible for a MISSED appointment fee of $50.00.
Financial AgreementClient Registration and Financial Agreement • September 2nd, 2014
Contract Type FiledSeptember 2nd, 2014
CLIENT REGISTRATIONClient Registration and Financial Agreement • July 26th, 2022
Contract Type FiledJuly 26th, 2022
Client Registration and Financial AgreementClient Registration and Financial Agreement • December 26th, 2019
Contract Type FiledDecember 26th, 2019With the exception of emergencies, a minimum of 24 hours’ notice is required for cancellation of appointments to avoid being responsible for a MISSED appointment fee of $50.00.
NEURODIVERSE COACHING CLIENT REGISTRATIONClient Registration and Financial Agreement • July 24th, 2023
Contract Type FiledJuly 24th, 2023
FINANCIAL AGREEMENTClient Registration and Financial Agreement • October 3rd, 2018
Contract Type FiledOctober 3rd, 2018
Client RegistrationClient Registration and Financial Agreement • August 16th, 2018
Contract Type FiledAugust 16th, 2018