Janet Nicholas OnLine Payments

Credit Card And Paypal Payments This form is for clients to send in payments of specified and unspecified amounts. Please use a submit button or enter an amount into the form below to make a payment.

Payments through Paypal

Quick Online Payments
Initial Evaluation - 45-50 minutes - $150.00
Individual Session (Psychotherapy) - 45-50 minutes - $120.00
Individual Session (Psychotherapy) - 20-30 minutes - $85.00
Family or Marriage Session - 45-50 minutes - $140.00
Family Consulting Services - 45-50 minutes - $250.00
No Show Fee - $80.00
Cancellation w/o 24 hr Notice - $80.00
MMPI Testing - $140.00
Connors ADD/ADHD - $60.00

Equine Assisted Induvidual Session:
Equine Teambuilding Session:
Wellness Workshop Classes
Insurance Co-Pay Due:
Balance Due:
Anything not mentioned above,
enter detail and amount

Pre-Arranged Payment Amount:

Pre-arranged Details:

Pre-arranged Amount:

You can contact Michelle at Medical E-Bill, my insurance representative by phone at 281-693-0482, by fax 281-569-4624, or click the "VERIFICATION" form at Medical E-Bill..