OPTIONAL CREDIT/DEBIT FORM

The credit/debit card form is, of course, completely optional; please complete it if you would like us to keep your information on file to charge services for your convenience.

Please click on the link below to download and print the Credit/Debit PDF form. Remember, this is entirely optional.

Credit/Debit Card Form (Optional)

Please click the links on the top toolbar for
REQUIRED FORMS or
Therapists' FEE SHEETS.

For our location please see the contact page,
or call 706-425-8900 for directions.