Authorization
Credit Card Authorization Update Form:
Welcome to our secure credit card re-authorization form:
Firstly, if you are a new client, you are almost certainly at the wrong form. Please proceed to our Full Consent Forms and complete them prior to your first session.
This form is for previously existing clients only.
"Existing clients" means clients who have already completed our three required intake forms: our Standard Consent, Virtual Therapy Consent, and Credit Card Authorization, and have already attended their first counselling session in-office or virtually.
This form exists for situations where, due to simple credit card expiration, compromised credit cards or other reasons, a need has arisen to replace a means of payment. It modifies an existing agreement to Psychological Counselling, rather than replacing or substituting for it.
To provide the highest standard of privacy currently available, we encrypt all of our forms using SSL and then add a second layer of Public Key Encryption using PGP technology - ensuring the complete security of your credit card information both at rest and in transport.
