Sign-up & Client Agreement
Below, you will find prompts to fill in and submit your personal information as well as your agreement to the terms of our contract.
This programme was developed by Janie Loubser, a Clinical Psychologist. This agreement gives you information about Janie's professional credentials, the programme content and payment, as well as the general terms and conditions of our work together. In order to sign up for the programme, you are required to submit your personal details which will be treated as confidential. By completing and signing this contract, you agree that the information you provide is correct and that you understand and accept the information provided here.
1. Cost and Payment Details
The duration of this programme is 6 months
The cost of this programme is R 2 000 per month
Payment is due on the day of the month you sign up (R 2000)
Subsequent payments (of R 2000) are due on the same day, monthly
For best results, quitting the programme mid-way is not advisable
Cancellation* requires one full calendar month’s notice (see below)
*If, for whatever reason you are unable or unwilling to complete the full six-month programme, you are required to give one full calendar month’s notice to avoid being liable for subsequent payments. If the cancellation notice is given with any fewer than one calendar month’s notice (until the next payment is due), one last instalment of R 2 000 will be due upon cancellation.
ENLIVEN Health (Pty) Ltd
FNB Business Cheque Account
Branch Code 250655
Account No. 62703126963
NB: Please send proof of payment to email@example.com
2. Medical Aid Claims
If you are claiming back from medical aid, please indicate it on the Client Details Form together with your medical aid details. After each session, you will receive a statement with the correct codes that you can submit to your medical aid.
3. Bookings and Cancellations
Sessions need to be cancelled at least 2 business days in advance of a scheduled session by emailing firstname.lastname@example.org
If I don't respond within one business day, it means your cancellation has not been received and needs to be re-sent
The 2 business day rule applies to the time and date sent emails and/ re-sent email are received by me, not when sent
Any cancellation email received with fewer than 2 business days’ notice is considered a late cancellation** (see below)
The same applies to any scheduled mobile/web-based sessions (e.g. Video Call, Mobile Chat, Email or related channels)
Any risk of session interruption due to technical difficulties are shard 50/50 by Janie and the client, should they occur.
**Late cancellations will result in the loss of a session. If you are unable to make a session due to illness or emergency, it is still seen as a late cancellation. The same applies if you forget or fail to show up for a session, for whatever reason or excuse.
The aim of this programme is to help you grow as a person, be self sufficient, independent and empower you to achieve your goals. The information given in this programme is therefore not a substitute for professional medical, psychiatric or psychological treatment. The programme, content and readings are not suitable to treat diagnosable disorders or medical conditions. Always consult a medical professional.
Any use of information in this programme is at the client’s discretion and own risk. Neither the author, nor the company can be held responsible for any loss, claim, or damages arising from the use, or misuse of the suggestions made, the failure to take medical advice, or for any third party material that may be referred to.
All rights reserved by the author. No part of this programme and its reading material may be reproduced by any mechanical, photographic or electronic process, or in the form of a phonographic recording. It may only be saved and copied for the client’s own use for this programme. No part may be shared other than ‘fair use’ to promote the programme without prior written permission of the author.