BIPP Fee Payment

BIPP Payment Form

Please complete the required information below to process your BIPP group payment. For questions please contact the Safer Path Administrative team at 830.569.2001 option 2.
BIPP Client Information*

First NameLast Name
Email*
example@example.com
Date*

MonthDayYear
Date

My Products

Weekly BIPP Fee

$25.00 Quantity

BIPP Intake Appointment Payments must be made before the Intake appointment or at the time of the appointment. Service will not be provided if payment is not made. Payments will not be refunded if the client is a no-show. The payment will be considered a donation to Safer Path.

$40.00

Weekly BIPP (Reduced Fee)**IMPORTANT** This ammount is only to be paid for those who qualify

$15.00 Quantity

Total

$0.00

Credit Card

Should be Empty:

BIPP Payment Form

Credit Card