Therapist
Afua Forson
Amy Shuman
Bambi Rattner
Brian Powell
Jordan Hamilton
Nikki Gamache
Peter Bishop
Vickie Alston
No elements found. Consider changing the search query.
List is empty.
First Name
Last Name
Email
*
Phone
*
Retreat Type
*
Standard
KAIR
No elements found. Consider changing the search query.
List is empty.
Full Days
*
0
1
2
3
4
5
6
7
No elements found. Consider changing the search query.
List is empty.
Half Days
*
0
1
2
3
4
5
6
7
No elements found. Consider changing the search query.
List is empty.
How Many Medicine Days
*
1
2
No elements found. Consider changing the search query.
List is empty.
Payment Amount
*
Client Payment Method
*
Self-Pay
Financing
Client Paid Upfront
No elements found. Consider changing the search query.
List is empty.
Does the client need to split the final payment?
*
No, charge total to original payment method
Yes, send client new payment links
No elements found. Consider changing the search query.
List is empty.
Split-Payment Details
*
Is the client owed a refund?
*
No
Yes
No elements found. Consider changing the search query.
List is empty.
Refund amount
*
Submit