Review & Agree to Policies

Please read each document. After reviewing, check the box at the bottom to acknowledge. Official documents will be sent for your e-signature after submission.

I have read, understand, and agree to all of the following documents of Legacy Family Services, Inc.: (1) Informed Consent for Treatment; (2) HIPAA Notice of Privacy Practices; (3) Telehealth & Communication Policy; (4) Consent for Use of AI Tools; and (5) Practice Policies, Cancellation & Financial Agreement. I specifically acknowledge that I must provide 24 hours notice to cancel, that late cancellations and no-shows will be charged $100.00, that I authorize Legacy Family Services to charge my credit/debit card on file for all fees described, and that I agree I will NOT dispute, chargeback, or contest any authorized charges.