You can sign and fill out all forms online 

INSTRUCTIONS: Please only complete these forms AFTER scheduling an intake appointment with Lisha Song.

Start with the Disclosure Form below.
After you sign and date it you will get confirmation and the next form link.
Continue through the whole sequence of forms. There are a total of 5 forms, but the first 3 are for signature only. When you click submit, your form is emailed to Lisha Song.

You can now save your progress as you go and come back to the form.
If you need to start again come back to this page and click on the form.

START HERE

1. Disclosure Form

2. Intensive Healing Disclosure

3. Receipt of Hippa

4. New Client Information

5. Initial Client Intake

Intensive Trauma Healing Program Fees

 A 50% deposit is collected at the time of scheduling your session and only after an Intake & Assessment have been completed (1-hr session completed either in person, over the phone, or virtually online).  Please click on the box below to pay your deposit.

Fees:

• $600 for Half-Day Intensive (up to 3 hours); deposit to reserve your time is $300. 
• $1200 for Full-Day Intensive (up to 6 hours); deposit to reserve your time is $600.

Although I am not contracted in-network with any insurance company, I can provide a medical receipt (aka: Superbill) for you to submit to your insurance company directly. They usually reimburse your out-of-pocket expense, at least partially. You may want to contact your insurance company to get the specific details of your Out of Network benefits.

Cancellation Policy

Because so much time is set aside for your Intensive Healing Program, the cancellation policy is different from an individual (1-hr) appointment. If you cancel your appointment with at least 5 days notice, your deposit will be applied toward a future, re-scheduled appointment within 30 days of the originally scheduled appointment. Because of the nature of scheduling longer, intensive sessions, there are no refunds once payment has been received. If you are ill or have a medical emergency (not work related) on the day of your intensive session, your deposit will be applied toward a future, rescheduled appointment within 30 days of the originally scheduled appointment.

*There is a $50 discount if paying with cash  for each HALF-day intensive session. Must be paid in full when scheduling the sessions.

*There is a $100 discount if paying with cash for each FULL-day intensive. Must be paid in full when scheduling the sessions.

***Payment plans are welcome, but cannot be combined with the cash discount.***

Spiritual Intuitive Coaching Program

Fees:

• $800 for 1-month of coaching (90 min per week - 4 sessions total). Pay in full or in monthly installments.
• $2400 for 3-months of coaching (90 min per week - 12 sessions total). Pay in full or in monthly installments.

Cancellation Policy

You have 48 hours from the time you submit payment to request for a full refund. After 48 hours from payment submission, there are no refunds.

Please give at least 24 hours notice to cancel or reschedule a coaching appointment. If you do not show or cancel without 24 hrs notice, you will lose a session from your coaching package.

*There is a $100 discount if paying with cash.