Client Payments

Please use this form to process your payment. When you click submit, you will be redirected to PayPal’s website to enter your credit card information and complete your payment. It is not necessary to have a PayPal account. Thank you.

Name*
First Last
Email*
Phone*
Therapist Name*
Date of Service*
Date Format: MM slash DD slash YYYY
Payment Amount*
Total
$0.00