By signing below , I authorize Greater Height Holistic Psychiatry PLLC to keep my signature and my credit card information securely on-file in my account. I authorize Greater Heights Holistic Psychiatry PLLC to charge my credit card for any agreed upon payments. I have reviewed the updated financial policy of Greater Heights Holistic Psychiatry PLLC. If the credit card that I give today changes, expires, or is denied for any reason, I agree to immediately give Greater Heights Holistic Psychiatry PLLC a new, valid credit card which I will allow them to charge over the telephone. Even though Greater Heights Holistic Psychiatry PLLC is not processing the new card in person, I agree that the new card may be used with the same authorization as the original card I presented.
