I certify that I have read and understand the above information to the best of my knowledge. I understand that I am responsible to pay as services rendered. I understand that I am responsible for any fees that will acquire for legal action being taken to collect my debt. I further understand that if a payment becomes 30 days past due, delinquency at the lesser of the annual rate 18% , or the maximum allowable rate, will be due on delinquent amounts from the date the payment was due. I acknowledge that there is a fee for bounced and checks and that I may lose my rights to use checks. Our office is entitled to a minimum of 48 hours cancellation notice. We reserve the right to charge cancellation fees for missed or broken appointments.