Four-Day Family Program Payments

Family Therapy Program Payments

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One family member is able to attend the four-day Family Program at no additional cost. Each additional family member must pay the fee listed below.

Family Therapy Program - additional family members

Price: $400.00

Name of family member or friend in treatment

(This information will be kept confidential.)

First Last

Names of all family members attending the program*

Payment Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Email*

Total

Terms and Conditions*

Refunds for the Family Program and Early Recovery Group are non refundable.

I understand

Credit Card

Card Details

Cardholder Name

Phone

This field is for validation purposes and should be left unchanged.

Not sure if you or someone you love needs help? Call our Admissions Staff who can help you assess the next step at 336-553-6596.

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