8_2026 1:1 Payment Options

10-hour discounted packs

Receive 10% off if you prepay for 10-hours. ($1,080)
Personalized 1:1 Sessions

Engage the Brain provides individualized support for learners from PreK through adulthood.

Services
Reading, Writing & Spelling Intervention (Orton-Gillingham)
Multisensory Math Instruction
Academic Support
Executive Functioning Coaching
Speech & Language Therapy
Locations: In-person, virtual, and select off-site locations, including schools and homes.

Pricing
Standard Rate: $120/hour
10-Hour Prepay Pack: $1,080 — Save 10%!

Sessions are typically 60 minutes. For 45-minute sessions or other session lengths, prepaid hours will be prorated accordingly.

About Your 10-Hour Pack
Packs may be purchased at any time during the school year.
To receive the discounted rate, the pack must be purchased before sessions are completed.
The discounted rate applies to sessions completed through May 31, 2027.
Packs do not automatically renew.
Credit card information submitted through this form is not stored for future purchases.
Would you like your 10-hour pack to automatically renew? Contact Lori, our bookkeeper, at 407-636-9281 or info@engagethebrain.org to set this up.

Cancellations
Please provide at least 24 hours’ notice when canceling a session. Sessions canceled with less than 24 hours’ notice are charged at the full session rate.

You may cancel directly with your specialist or contact Engage the Brain at info@engagethebrain.org, 407-636-9281, or text 407-310-9583.

Ending Services & Refunds
We require two weeks’ notice when ending services.

Unused prepaid hours may be refunded upon written request. A $35 processing fee applies. Any hours already used will be recalculated at the regular $120/hour rate, and the remaining balance will be refunded.
Questions?

If you need assistance with this form or have questions about any of our selections, please feel free to contact us:

Office: 407-636-9281 (voice)

Voice/Text: 407-310-9583

Email: info@engagethebrain.org

Click the link to set up a free 20-minute phone/zoom consultation.

Check out our website: www.engagethebrain.org

Student Name

First NameLast Name
My learner:

Other

Parent/Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
2nd Parent/Guardian Name (optional)

First NameLast Name
Mobile Phone

Area CodePhone Number
E-mail

Your learner’s scheduled session is a dedicated time reserved specifically for them and their specialist. We require at least 24 hours’ notice for cancellations; sessions canceled with less than 24 hours’ notice will be charged in full. Please initial below to confirm that you have read, understand, and agree to our Reserved Session Time Policy.
Purchase of a discounted 10-hour pack terms: Funds are available for discounted (10% off) EtB 1:1 services through May 31, 2027. Any remaining funds will be available for any EtB service at a non-discounted price.To request a refund of remaining funds please notify EtB in writing (info@engagethebrain.org) within 60 days of last day of service. A $35 processing fee will be deducted from any refund. All remaining funds will be forfeited after 60 days. Please indicate you understand by typing your initials below.
SICKNESS: Any person with signs of sickness, including, but not limited to fever, running nose, coughing, sore throat, or body aches should not come to EtB. This is regardless of a negative testing (covid, flu, etc). Students may be offered the option to join the session virtually due to this type of situation. Please indicate you understand by typing your initials below.
Engage the Brain will do their best to provide a healthy and clean environment. Please indicate you understand by typing your initials below.

Registration & Payment
By signing and submitting this registration form, you acknowledge that you have read, understand, and agree to the policies outlined above.

Enter your credit/debit card information below to complete payment for your discounted 10-hour prepaid package. Once payment information is entered, click “Register” to submit your registration and payment.

This is a one-time payment. Your payment information from this form will not be saved or used to automatically purchase another package.

Once your prepaid hours have been used, sessions will be charged individually at the regular hourly rate using the payment method we have on file.

If you would like us to automatically purchase another discounted 10-hour package, please contact our office at 407-636-9281 or info@engagethebrain.org to provide authorization. You may also submit this form again to purchase another package.

Questions? Please contact Lori, our bookkeeper, at 407-636-9281 or info@engagethebrain.org.
Acknowledgement: Parent/Guardian Print Name

First NameLast Name
Signature
Today's Date

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Select the discount pack(s) below.

Discount 10-hour pack 1:1 Intervention or Therapy. DISCOUNTED 10, one-hour sessions in 1:1 setting working with an Engage the Brain Learning Specialist or Speech/Language Pathologist. Includes all of Engage the Brain 1:1 services.

Discount 10-hour pack 1:1 Intervention or Therapy$1,080.00

DISCOUNTED 10, one-hour sessions in 1:1 setting working with an Engage the Brain Learning Specialist or Speech/Language Pathologist. Includes all of Engage the Brain 1:1 services.

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10-hour discounted packs

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