Client Payment Agreement and Cancelation Policy

I understand that I am financially responsible for payment of all services received in the amount stated below. I agree to pay the amount in the same period stated below or as otherwise agreed upon by all parties involved.

I understand that I will forfeit any future services until balance is paid in full.

For professional services rendered for health and wellness, I agree to pay Kaye Sharp PT (Sharp Physical Therapy & Health Consulting) the sum total of :

____$165 for 1 visit (including initial evaluation)

____$150/ visit for 2-5 pre scheduled visits

____$145/ visit for 2 visits per week for 1+ months

____$140/ visit for 3 visits per week for 1 + months

____ other agreed upon amount _____

Payments will be received at the time of service or via weekly/monthly invoice:

____PayPal ____CC ____Venmo ____Cash ____ Check

CANCELATION POLICY

In order to provide efficient and effective services to all clients, please provide a minimum of 24 hours advanced notice for all cancelations (except for emergencies). For repeat offenders (multiple late cancelations), a 50% cancelation fee will be applied to your balance.

I have read, understand, and agree with the Client Payment Agreement and Cancelation