For more information:
(603) 247-4191 / drrobin@insightsgroup.net

Credit Card Authorization

I authorize Insights Group and its representative to charge my credit card/HSA card after each scheduled session at the agreed upon rate. I also authorize my account be charged for a late cancellation (24 hours or less from the time of the scheduled appointment) or a “no show” appointment at the full session rate.

  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.
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