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HOME ABOUT US SERVICES RESOURCES CHAT
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254 S. Ronald Reagan Blvd.,

Suite 130,

Longwood, FL. 32750

407.774.2284

 

 

OUR ONLINE SERVICES REGISTRATION, 

TERMS, CONDITIONS & DISCLAIMER

 

Before we can provide online counseling services, we must receive an electronic agreement to our disclosed disclaimer below from prospective client. Please read the information below, and, acknowledge your understanding by indicating so and submitting your electronic agreement.

 

 

First Name:

Last Name:

Address:

Street:

City:

State:

Zip Code:      

Phone (e.g., 407.999.9999:

E-mail:

Password:

Confirm Password:

Service Seeking:

Online Counseling/Chat

Divorce Class

Family Mediation

Initial Comments/Concerns:

(limited to 350 characters)

 

Acknowledgement. I agree that I have read and agree to A Better Therapy's disclaimer information and terms and conditions posted at their website about their online counseling/chat services. By indicating "I Agree" below, I understand that I am fully acknowledging my understanding of the extent and/or limitations of these services.

 

 

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