FEE POLICY of Aspens & Oaks Counselling Services (AOCS)
(NOTE: Page is Formatted the same as our Hard Copy Sheet except for Online Submit Option)
Listed below are the important points pertaining to the AOCS Fee Policy. Please read and understand these points before signing. Ask staff or your clinician questions to clarify as needed.
- Client payments can be made by etransfer, debit or cash. A Credit Card option is currently not
- We prefer that all clients who are responsible for all of or a portion of the session fee (co-pay) to do so prior to their session using their online banking via etransfer to email@example.com.
- You can use the debit or cash options for appointments that begin prior to 4:00 PM.
- Receipts are issued for all payments made and may be used for insurance submission.
- With your permission we can email receipts. If you have not provided staff with your email prior it is ________________________@__________ Please initial if OK with email receipts. ______
- Please advise us beforehand of any special circumstances that would interfere with the prompt payment of your account.
- For EAP Clients: Sessions that exceed your prior EAP allotment will be billed to the client at our current posted hourly rate of $________. While our staff or your clinician may mention your allotment prior to it ending they will certainly provide that information if asked; however, it is ultimately the client’s responsibility to know their allotment usage.
- There is a fee to ALL CLIENTS for appointments not kept and/or cancelled without prior 24-hour notice. The charge for this is our current posted hourly rate of $________. Note: This 24 hour notice policy applies to all clients because EAP providers will not pay missed appointments.
- Interest will be charged on overdue accounts at a rate of 2% per month.
FEE POLICY CONFIRMATION
By clicking SUBMIT below I confirm that:
I have read and understand the AOCS fee policy provided to me as per the points listed above. I agree that I and/or my EAP are responsible for paying the agreed hourly rate for the services received at AOCS as per the policy points listed above.