Life Architecture

Form 3-E — Dr. Lisa M Hill

Financial Responsibility & Payment Agreement

This agreement outlines the financial policies and expectations for services provided through Dr. Lisa M Hill. Please read carefully before signing.

Session Fees

Session rates are established prior to beginning services.

Standard Session (approximately 50 minutes) $75
Couples Session (approximately 75 minutes) $135
Family Session (approximately 50 min pp — includes 3 people in same household) $175
Extended Sessions As arranged

Any changes to session length or structure will be discussed and agreed upon in advance.

Payment Responsibility

Payment is due at the time of service unless otherwise arranged. A valid payment method may be kept on file to support consistent and timely processing.

You are responsible for all fees associated with scheduled services.

Scheduling & Reserved Time

Sessions are scheduled in advance and reserved specifically for you. This reserved time is held exclusively and is not offered to others once booked.

Cancellations & Missed Sessions

If you need to cancel or reschedule, please provide at least 24 hours' notice.

Sessions canceled with less than 24 hours' notice, or missed sessions, may be subject to the full session fee. This policy helps protect the integrity of reserved time and supports consistency in the process.

Ongoing Agreement

Engaging in services indicates an understanding of and agreement to these financial policies. If circumstances arise that affect your ability to continue, communication is encouraged so that appropriate next steps can be considered.

Acknowledgment & Signature

By signing below, you acknowledge that you have read and understand the financial policies outlined above and agree to be responsible for payment of services as described.

Up to 4 clients may sign below (e.g. couple or family members). Additional names are optional — at minimum, the primary client must sign.

Typing your name constitutes your electronic signature.