Cancellation Policy Please enable JavaScript in your browser to complete this form. Client Name Signature Please review the cancellation policy below. By signing at the bottom, the client acknowledges they have read and agree to this Cancellation Policy for Effect Behavioral Health Inc. Appointments must be cancelled or rescheduled in advance. All cancellations must be made by contacting the therapist directly by text or email within 24 hours. Late cancellations and no-shows may be subject to a fee. Cancellation fees are $175.00. All no-shows will result in discharge unless deemed otherwise by the therapist or due to emergencies. Please contact Effect Behavioral Health Inc. as soon as possible if you need to change your appointment. Client agrees not to dispute charges because he or she agrees to 24 hour notifcation policy. Client Name *FirstLastDate *Client Signature * Clear Signature By signing this contract; client agrees to all the statements above.Submit Please enable JavaScript in your browser to complete this form.Please review the cancellation policy below. By signing at the bottom, the client acknowledges they have read and agree to this Cancellation Policy for Effect Behavioral Health Inc. Appointments must be cancelled or rescheduled in advance. All cancellations must be made by contacting the therapist directly by text or email within 24 hours. Late cancellations and no-shows may be subject to a fee. Cancellation fees are $175.00. All no-shows will result in discharge unless deemed otherwise by the therapist or due to emergencies. Please contact Effect Behavioral Health Inc. as soon as possible if you need to change your appointment. Client agrees not to dispute charges because he or she agrees to 24 hour notifcation policy. Client Name *FirstLastDate * Signature Date Client Client Signature * Clear Signature By signing this contract; client agrees to all the statements above.Submit