For those choosing to pay by payments using our Easy Pay Payment plan.
Payment Plan Terms and Installment Payment Agreement
(Services where fees are less than $500.00 are not eligible for payment plans)

In choosing the “Payment Plan Option” I the participant agree to the following irrevocable terms:

General Terms:

I the participant agree that,
1. An initial prepaid deposit of a minimum of 30% of the regular fee for services will be charged at signing (either electronically or physically.
2. The balance will be paid/charged as indicated below in this payment agreement.
3. Initial payment will be made using MasterCard, Visa or in cash (no checks please).
4. A 10% service fee will be added to the regular price for services, with all payment plans
(BodySmart Wellness LLC is not a lender. As a courtesy to it’s patrons, BSW is offering this payment plan. The service fee is to offset BSW’s time and other expenses related to this offer.)
5. All payments thereafter will be automatically charged to the participant’s MasterCard or Visa (No checks, American Express or Discover cards)
6. All payment plans are irrevocable from the time registration forms are submitted by the participant.
7. I the participant am required to pay the required initial payment prior to services being rendered by the provider.
8. Electronically filling out and submitting registration form(s), constitutes my (the participants) electronic signature
9. I the participant will also be required to physically resign the form(s) upon arrival at BodySmart Wellness
10. If completing paper form(s), the “Payment Agreement” is irrevocable from the time of signing.

I Am Registering for:

Hypnotherapy, Life Coaching, Counseling with Dr. Holder
3 session program
8 session program

hcg Rapid Weight Loss Programs
Full Cycle
Half Cycle

Hormone Replacement Therapy
Fees Contingent On Dosages. Please Contact The BodySmart Wellness Office For Specifics

Hypnotherapy Certification
Instructor Training

Hypnotherapy Training Materials Complete Student Library
Complete Library

I agree to be charged an initial deposit of 30% of the fee(s) associated with the program(s), Session(s), Course(s) that I have listed/checked above.
I agree that the balance will be divided into 3 equal payments that will be charged to my credit or Debit Card on a bi-weekly bases.

Note: All first/initial appointments are billed to your credit card at the time your appointment is scheduled. Subsequent payments will be billed to your card as indicated in this agreement. Even if other payment arrangements are made with BodySmart Wellness LLC, a credit card must be on file at the time the appointment(s) is made. Any special arrangements must be in writing and approved by the provider. Appointments missed without 24 hours notice will be billed to the patient’s/client’s/customer’s card at the standard rate for the time or program reserved “or” a session will be forfeited at the provider’s discretion. Fifteen minutes or more may be considered a missed appointment at the discretion of the provider. This is to avoid inconveniencing commitments of the provider and or other patients that are scheduled after your appointment. Each person’s time is set aside especially for them (including you). We make every attempt to stay on schedule so as not to keep you (or the person after you) waiting. Any emergency after hours or weekend appointments are an additional $75.00 per session. Fees may change from time to time without notification. In signing this document you agree to be responsible for fees for services and/or products at the newer rate when such changes occur. Fees may change from time to time. New fees are available by request so please ask if you are unsure of current fees. All programs sessions purchased and/or individual sessions must be used within 365 days (1 year) from date of purchase or registration (whichever came first) or they expire with no refund of any unused sessions. Re: Requests to cancel an un-started program: If at the sole discretion of the provider, the provider agrees to allow cancellation of a program or session after registration, a minimum $50.00 to a maximum $500.00 processing fee will apply. No cancellations can be made the day of any program or other appointment.

I the Patient/Client/Customer/Student am aware that I am purchasing One (1) (or more) program(s) or courses comprised a specified number of sessions, meetings classes etc. and I understand that I am not purchasing or paying for individual sessions. I understand that all program, session course etc. purchase are completely non-revocable, non-rescindable, non refundable and final and that even if the participant decides, for any reason, to discontinue or not move forward with the program(s), session(s), course(s) or any other such purchase, that the purchaser remains responsible for payment of the entire amount of the program(s), session(s), course(s) etc. purchased. The Patient/Client/Customer/Student agrees that if he or she fails to pay as agreed, he or she will be responsible for all reasonable collection costs and legal fees associated with the collection of this debt. Any payment(s) payments set forth in this agreement, and/or any attempt by BodySmart Wellness LLC to collect the agreed to payment(s), that is refused for payment to BodySmart Wellness LLC. by the purchasers’ financial institution (Bank etc) will be assessed a $75.00 fee per incident. The provider/BodySmart Wellness LLC and the Patient/Client/Customer/Student will agree, either prior to the start of services or after the first session/meeting, as to what program(s) the Patient/Client/Customer/Student will participate in. I the Patient/Client/Customer/Student understand and authorize that my credit card will be automatically charged as indicated above in this document.

Pricing and plans subject to change without notice. Any changes will be updated on the BSW website as quickly as we are able
Discounts cannot be combined with other offers, redeemed for cash, transferred and may be withdrawn at any time by management.

Purchaser’s Name:

I agree that by my clicking “Submit” I am agreeing to the above terms.