Payment Policy I acknowledge that payment is expected at the time of service. I also understand it is my responsibility to be sure of my insurance benefits and to be sure my insurance carrier is paying correctly. I understand that benefits may be different for virtual and in-office services. I acknowledge that it is my responsibility to pay for services provided by Broward Center for Counseling. NO TEXT OR EMAIL IS ACCEPTED FOR ANY CANCELLATION OF AN APPOINTMENT(S) - YOU MUST CALL THE OFFICE, LEAVE A MESSAGE AT EXTENSION 200.
Patient Name(Required)