Cancel Policy | Inward Journey

Cancellation Policy Form

If you are unable to attend an appointment, we request that you provide at least 24 hours advanced notice
to our office. Since we are unable to use this time for another client, please note that you will be billed for the entire cost of your scheduled appointment if it is not timely cancelled, unless such cancellation is due to illness or an emergency.
For cancellations made with less than 24 hour notice (unless due to illness or an emergency) or a scheduled appointment that is completely missed, you will be mailed a bill directly for the full session fee.

We appreciate your help in keeping the office schedule running timely and efficiently.

Please complete the Cancellation Policy Form below.

First Name

Last Name

I agree to the terms & conditions

If you are unable to attend an appointment, we request that you provide at least 24 hours advanced notice to our office. Since we are unable to use this time for another client, please note that you will be billed for the entire cost of your scheduled appointment if it is not timely cancelled, unless such cancellation is due to illness or an emergency. For cancellations made with less than 24 hour notice (unless due to illness or an emergency) or a scheduled appointment that is completely missed, you will be mailed a bill directly for the full session fee. We appreciate your help in keeping the office schedule running timely and efficiently.

Client Signature (Client’s Parent/Guardian if under18)

Select a date

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Inward Journey Counseling

Peoria Counseling Service

309-472-0798

Cancellation Policy Form

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JOURNEY
COUNSELING