Bloom Recovery Network
Balance Payoff
Client Name
*
First Name
Last Name
Email
Add email for a receipt confirmation of payment
Payment Options Below
ALL PROGRAMS MUST BE PAID IN FULL 7 DAYS PRIOR TO THE PROGRAM START DATE.
MAKE PAYMENT BELOW and THEN SELECT "SUBMIT."
My Products
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Initial Deposit
$
50.00
Double Room Full Fee
All registrations received after 12/31/23.
$
425.00
Double Room Payoff (after -$50 deposit)
All registrations received after 12/31/23.
$
375.00
Single Room Full Fee
All registrations received after 12/31/23.
$
550.00
Single Room Payoff (after -$50 deposit)
All registrations received after 12/31/23.
$
500.00
ROOM UPGRADE from a single to a double.
Only select this option if you have already paid in full for a double room and want to change to a single room.
$
125.00
2023 pricing - DBLE RM Full Fee
$
400.00
2023 pricing - DBL RM Payoff (after -$50 deposit)
$
350.00
2023 pricing - SIN RM Full Fee
$
525.00
2023 pricing - SIN RM Payoff (after -$50 deposit)
$
475.00
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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