Paradigm in Motion Appointment Request Form
Please fill out this form to request an appointment
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Email *
Which service are you requesting? *
Which day and time works better for you? *
Please list 3-4 dates that work for you, on Fridays or Sundays (EDT), starting 2 weeks from today. *
On occasion and with advance notice, I may be a little more flexible with dates and times.  Do you have any extenuating circumstances that require a different date and time? *
After I email you a confirmation of a date and time, I will hold the time for you for 48 hours.  You must pay for this spot within 48 hours or lose your spot.  Do you agree?

Payment can be made at paradigminmotion.com, and there are multiple payment plan options available.
 *
This session is not a substitute for any medical advice or treatment.  Please consult your doctor for medical treatment. *
Do you agree to have a strong internet connection, headphones with a microphone attached, and a computer or phone with Zoom capabilities?  It is important that I see you and hear you clearly. *

All bookings are finalized with non-refundable payment. You may reschedule one time, up to 48 hours before your scheduled date and time. By booking you are committing both of our time. You may not reschedule less than 48 hours prior to your appointment.

 *
Sessions must start on time.  I reserve the right to leave the Zoom if you are not present at the agreed upon time. *
Do you have any questions or concerns? *
A copy of your responses will be emailed to the address you provided.
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