Consent of Fee for Services

Payment Required Before Services Provided

The full payment for services must be received prior to the start of the services. This allows us to focus on the content of our appointment without worrying about the hassle of payment.

You can either choose to pay when you book or pay later. If you choose to pay later, the payment will be processed during the 24-hour period prior to your appointment. Therefore, you will need to have a credit card on file.

A receipt will be provided to you when payment is received for you to submit to third-party insurance (if applicable).

Cancellation Policy

Twenty-four (24) hours notice is needed to cancel/reschedule your appointment. This gives an opportunity for someone else to use that appointment slot. If 24-hour’s notice is not provided, a fee of $25.00 will be charged to you.

Refund Policy

If you have pre-paid for sessions that you end up cancelling, the payment will be refunded to you. A $25 cancellation fee will be subtracted from the refund if applicable.

Notes regarding Medical Records

In accordance with the privacy policy, your medical records must be securely retained for ten (10) years as required by the College of Dietitians of Ontario. Even if you do not end up attending an appointment, any information you have given to me will be securely maintained in accordance to this requirement.

Record of Review