Enrolling in a Group

(single session)

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 (final step if you already have completed setup through Simple Practice, if not then proceed with step 4 and 5)
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 number

(###)

###

####

select your group

make sure to select correct group!

Payment Consent: I authorize Felicia Andrews Therapy to charge my credit card through SimplePractice for the payment of $75 for the group session.

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

Payment and Attendance Policy

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