Sponsorships - Lois Hermann & Associates

Sponsorship / Reduced Professional Fee Application

Thank you for choosing Lois Hermann & Associates for your mind, body, and spiritual self-care. If you are experiencing financial hardship and would like to request assistance with payment for your sessions, we are graciously willing to consider your situation. We offer opportunities for special sponsorship discounts for our programs and payment plan options.

Secure your session with the down payment, then complete and submit this form. Check the items on this list to acknowledge your understanding of our reduced-rate professional services agreement. Pending availability, you may be placed on a waiting list for our sponsorship program. We will discuss payment options at your scheduled appointment time.

We are grateful to be of service to those who are ready to do the work to embrace change. We hope to be able to assist you on your self-care wellness journey.

Many Blessings,
Lois Hermann & Team

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Name*

First Last

Email*

Phone*

To qualify for our reduced fee program, please share a brief description of your situation.

What are you doing to assist humanity?

How will you benefit from the gift of this arrangement.

Please check the box to indicate you agree with the following if you are selected:*

I agree to show up on time for all scheduled appointments.

I agree to secure my sessions with a deposit and arrange to make payments for any balance owed.

I agree to provide 48-hour notice to cancel an appointment or be responsible for the full amount of the session.

I understand this agreement will terminate if I miss two (2) scheduled sessions without 48-hours notice.

I am responsible for payment of my care and that of my children for any amount due, even after this agreement terminates.

I agree to provide a written testimonial for the treatment received within one week of completing the program.

I have read, understand, and agree to the provisions of this partial Sponsorship Agreement.

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Date*