Enrolling in a Group

Fill out and submit this pre-enrollment form
Make sure to select the correct group series and times
Select a payment option and enter initials to authorize charges
Next you will receive registration paperwork via email through Simple Practice with payment setup
Once you complete the registration paperwork and payment setup via Simple Practice your credit card is charged you’re enrolled

Name

First Name

Last Name

Email

Phone

(###)

###

####

Select your group

Toddler Mom Mondays 1:00 pm (3 sessions)

Nurturing Motherhood Mondays 2:30 pm (3 sessions)

Select a payment option

(payment setup is Simple Practice)

Full Payment (One-Time Payment: Pay the entire amount upfront in one payment)

Two Payment Plan (Pay half of the total amount upfront and the remaining balance halfway through)

Payment Consent: I authorize Felicia Andrews Therapy to charge my credit card through SimplePractice for the payment plan selected: (1.) For Full Payment: The full $300 will be charged before the first session. (2.) For 2-Payment Plan: Payments of $150 will be charged before the first and third sessions.

By typing my name below I consent to my chosen payment plan and authorize Felicia Andrews Therapy to process my payments as outlined above via my credit card.

Payment and Attendance Policy

This is a prepaid package with a commitment contract. You are being charged for the full series upfront, with the total fee covering 3 sessions, regardless of attendance. Once the first payment is made, there are no refunds, partial refunds, credits, or deductions for any reason. Please note that if you cancel or miss a session, no portion of the fee will be refunded or credited. After the first payment, you are committed to the full series.