Client Service Fees:
I, the undersigned, certify I am financially responsible for all fees associated with the services rendered through STREST. I understand STREST does not participate in any health insurance or HMO plans. I understand STREST will not submit insurance forms on my behalf and any submission of forms to my insurance provider is solely my responsibility. I understand it is my responsibility to pay the full session fee on the same date services are rendered.
The information contained in this electronic correspondence is confidential and intended only for the use of STREST. Any dissemination or distribution of this confidential information is strictly prohibited.