Welcome to Pacific Northwest Massage, thank you for choosing me to assist in your recovery. Please take a moment to read the following patient agreement. If you have any questions regarding the payment policy, please do not hesitate to ask.

Please understand that your time commitment begins at the moment you schedule massage.  In order to make it fair for everyone, please consider your schedule carefully and don't commit to a time that you feel may be questionable.  There are times a cancellation or reschedule may be necessary, but our time together is important.  As a courtesy to all clients, please give as much advanced notice when possible. 

Missed or cancelled appointments, with less than twenty-four (24) hours notice, may be charged for the missed session.
Appoinment cancelled with less than twenty-four (24) hours notice ..........$35
(If session is able to be rebooked with another client, fee may be waived)
Appointment missed (no call/no show) ..........$60

Payment Policy:  Unless other arrangements are made, the policy is to require payment at the time of treatment.

Late Fees:
Any treatment fees remaining unpaid after 60 days will bear an interest rate of 12% until paid. If hiring an attorney or collection agency is required to collect the fee, the patient will be required to pay attorneys fees/court costs and collection fees.

If You Have Insurance:
If you have insurance and if possible, I will cooperate in processing the insurance claim and will wait for payment by the insurance company. If the patients insurance only covers a portion of the treatment fee, the patient will be required to pay the remaining portion (co-payment) at the time of treatment. If the patient is reimbursed directly by the insurance company, the patient agrees to make payment promptly. If insurance reimbursement isn't received within 60 days from the date of treatment, the patient will be required to pay the remaining balance and wait for reimbursement. In the case of a denial of coverage, the patient agrees to be responsible for the treatment fee in full.

Accident Cases:
If you were in an accident and injured by another party, I will cooperate in processing the claim against the other party. I may agree to wait for payment from the proceeds of any settlement or judgment. However, the patient is ultimately responsible for payment. If I agree to wait for payment, the patient and/or their attorney will cooperate and sign an assignment of the insurance/settlement proceeds that way payment may be made directly to me when the case is concluded.

Treatment Of Minor:
If the patient is a minor, as the parent or guardian of the minor, you are responsible for payment of treatment.