FINANCIAL RESPONSIBILITY

I agree to be financially responsible for all services rendered. Payment is due at the time of service unless otherwise arranged in advance.

CANCELLATION POLICY

A minimum of 24-hour notice is required to cancel or reschedule an appointment. Late cancellations or missed appointments may be subject to a cancellation fee.

INSURANCE (IF APPLICABLE)

If submitting services to insurance, I understand that I am financially responsible for any denied claims, deductibles, co-payments, co-insurance amounts, or balances not covered by my insurance provider.

MEDIA RELEASE

I authorize Modern Wellness and Pilates to use photographs and/or video recordings taken during sessions for educational, promotional, or marketing purposes. I understand that I may revoke this authorization at any time by submitting a written request.

ACKNOWLEDGMENT

By signing below, I acknowledge that I have read, understood, and agree to the policies stated above.