The Life Management Center

 Life Management Center Informed Consent Contract

 Please Print and Sign and Email Back

The law requires that clients sign a contract for services which may be terminated at any time by email or mail. I am willing to receive Coaching, Counseling and/or Therapy in the forms below from Adele Tartaglia, Bd. Cert. Ericksonian Hypnotherapist, Bd. Cert. Regression Therapist and Restructuring Therapist. Therapy may be on-site, by Skype, or by phone. I may at any time choose not to use these modalities.

I understand that none of these therapies are substitutes for traditional medical care, and that these Integrative Therapies are not intended to replace treatment by physicians. Counseling is not intended to diagnose or prescribe treatment for any illness or disorder. Anyone already undergoing physician-prescribed medication or treatment should seek the advice of his or her doctor before reducing the dosage or stopping such treatment.

I understand that Intake Sessions, Counseling, and Coaching are billed at $155/hour. Restructuring Therapy, Hypnotherapy, and Regression Therapy sessions are $205.

Addictions, Anger Management, Eating Disorders, Infidelity, OCD, Anxiety, Pain Management, PTSD, Smoking Cessation, and Weight Loss may require two or more Restructuring Sessions. Smoking and Weight loss are Tax Deductible therapies.

Payment is due before the session begins through PayPal,  For your convenience, you may use the PayPal Donate button on the site.

Monthly interest in the amount of 1.5% will accrue for uncollected accounts. Visa & MasterCard, cash and checks are accepted. The Life Management Center is the Counseling division of Alliance of Divine Love Inc. Chap 573, 1974,  501 © 3. Checks should be made out to the Alliance of Divine Love Inc., Chapel 573.

I agree to pay Adele Tartaglia in full for her therapy according to the terms of this contract.  




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