Payment Policy

Fees for Services

The fees for services provided by Alternative Pride Wellness are as follows:

• Individual Therapy (50 minutes): $60 per session

• Couples Therapy (50 minutes): $90 per session

• Multi-Person Group Sessions (50 minutes): $120 per session

Fees are based on the reserved 50-minute appointment time and will be charged in full regardless of whether the session ends prior to the conclusion of the scheduled 50-minute period.

Payment Expectations

Payment is due at the time of service. Accepted forms of payment include: Debit and Credit cards.

Insurance

If insurance is accepted or applied, clients are responsible for any copayments, coinsurance, deductibles, or non-covered services.

Outstanding Balances

Any outstanding balances must be paid in full before additional services are rendered, unless alternative arrangements have been approved.

Policy Agreement

By signing below, you acknowledge that you have read, understood, and agree to the payment policy outlined above. Alternative Pride Wellness may utilize my payment methods on file without additional authorization.

Payment Information Authorization and Maintenance

I agree to maintain a current, valid, and up-to-date payment method on file with Alternative Pride Wellness at all times. It is my responsibility to promptly notify Alternative Pride Wellness of any changes to my credit card, debit card, billing address, expiration date, account number, or other payment information.

I authorize Alternative Pride Wellness to charge my payment method on file for all fees associated with services rendered, including session fees, late cancellation fees, no-show fees, outstanding balances, and any other charges permitted under this agreement. If a payment is declined, rejected, or otherwise unable to be processed, I agree to provide an alternative valid payment method upon request and remain responsible for all outstanding balances.

Failure to maintain a valid payment method on file may result in suspension or termination of services until payment information is updated and any outstanding balance is resolved.

Cancellation Policy

To ensure the availability of appointments and to respect the clinical time reserved for each client, the following cancellation policy is in place. Appointment times are specifically set aside for each client, and due to limited availability, late cancellations and missed appointments impact both scheduling access for other clients and the clinician’s ability to provide services. When a client does not attend a scheduled session, that time cannot be offered to another individual, and the clinician is not compensated for that reserved appointment time.

Appointment Cancellations

Clients are required to provide a minimum of 24 hours’ notice to cancel or reschedule an appointment. Cancellations made with less than 24 hours’ notice will incur a cancellation fee. Rescheduled appointments must be completed within the same week of the original appointment. If the clinician does not have availability within that timeframe, the cancellation fee will still apply.

Late Cancellations

Appointments canceled with less than the required 24-hour notice will be charged a $60 fee for the first cancellation. The cancellation fee will increase by $10 for each additional session canceled, up to three sessions. After three (3) cancellations without being rescheduled, services may be subject to termination at the discretion of the clinician. 

No-Shows

Failure to attend a scheduled appointment without prior notice (“no-show”) will result in a fee equal to the full session rate. The no-show fee will increase by $10 for each additional session canceled, up to three sessions. After three (3) no-shows, services may be subject to termination at the discretion of the clinician. 

Late Arrivals

Clients who arrive late will be seen for the remaining portion of the scheduled session time. The full session fee will still apply, and sessions will not be extended beyond the originally scheduled end time.

Payment Method on File

A valid credit or debit card is required to be kept on file for all clients. This card will be used for the processing of session fees, cancellation fees, and no-show fees in accordance with this policy.

Fee Collection

All fees, including cancellation and no-show fees, will be automatically charged to the payment method on file on the date the appointment was originally scheduled.

Exceptions

Exceptions to this policy may be made at the discretion of the provider in cases of emergency or other extenuating circumstances.

By scheduling an appointment, clients acknowledge and agree to the terms of this Cancellation and No-Show Policy.

By signing below, I acknowledge that I have read, understand, and agree to the Payment and Cancellation Policies outlined above, and I agree to pay all applicable fees on the date services are rendered.

Payment Authorization Form

Acknowledgment