I authorize SpringSource Psychological Center, PLLC to charge my credit card for services and/or for any balance due that has not been paid 30 days after it is received.
I understand that if I miss the appointment or do not cancel 24-hours prior to the appointment, SpringSource Psychological Center, PLLC is authorized to charge my credit card the same amount as the missed appointment.
I have read and understand this form. I attest that the information below is true and accurate.
Have Questions?
We look forward to speaking with you.
You can call for more information or to schedule an in-person or virtual appointment at either of our office locations.
CHICAGO
53 W. Jackson Boulevard, Suite 520
Chicago IL 60604
NORTHBROOK
899 Skokie Boulevard, Suite 300
Northbrook, IL 60062
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If you prefer email, please submit the contact form at the bottom of this page.
We also offer free 15-minute initial consultations. Click below to schedule.
100% Confidential
Find Your Best Therapist in Chicago.At SpringSource, we believe that there are many paths to healing. Our goal is always to help you get back on your feet to lead a fulfilling life free from stigma and shame while improving your quality of life. It is never to late to find reovery. Begin Today!100% Confidential |
Serving Cook County, IL and the following cities: Chicago, Elgin, Cicero, Schaumburg, Evanston, Northbrook, Arlington Heights, Palatine, Skokie, Des Plaines, Orland Park, Glenview
