Please note: you will be given the opportunity later on to make a payment, provide the contact information for a third party you would like us to bill, or to indicate that Plymouth County Family Support Inc. will be funding services on your behalf
In the event of an emergency requiring medical attention, I understand that Sing Explore Create, LLC will make every effort to contact and notify the listed parent/guardian and emergency contact listed above. However, if neither can be reached Sing Explore Create, LLC reserves the right to call emergency personnel to transport the student/client to the nearest medical facility to secure necessary medical treatment. This applies to sessions at our center, at-home visits, and online sessions.
Note: When you click the submit button below, you will be redirected to another form where you will be able to make a payment, or identify a third-party who will be responsible for payment.
After submitting this form, you will also receive an automated email summarizing your responses here. This email may go to your spam folder.
If you have any questions or concerns, please contact Amanda at email@example.com