PPCC DRUG & ALCOHOL ASSESSMENT

PPCC DRUG & ALCOHOL ASSESSMENT

ASI APPOINTMENT FOR P.O. OR COURT
POLICY FOR A MISSED APPOINTMENT & RESCHEDULING FEE

Please be advised that missing two appointments will result in the forfeiture of your assessment fee. There are no exceptions to this policy. Our therapists have very busy schedules, so kindly ensure you are available when scheduling your assessment.

EXPECT AN ADDITIONAL EMAIL OR CONTACT VIA PHONE FROM THE THERAPIST.

Please be available at the appointment time. There will be an additional $65. fee to reschedule for a no call/no show. Please contact us for any changes in your schedule.

Thank you,
Mr. Edgar
I AGREE TO PPCC POLICY FOR MISSED APPOINTMENTS & RESCHEDULE FEE
Name*

First NameLast Name
YOUR Email*
example@example.com
YOUR Phone Number*
Please enter a valid phone number.
P.O. AGENT Name*

First NameLast Name
P.O /AGENT Email*
example@example.com
P.O. /AGENT Phone Number*
Please enter a valid phone number.
GIVE 3 DATES AND TIMES YOU ARE AVAILABLE

Appointments need to be scheduled at least 3 days after you plan to make your payment. You will then receive an email informing you of your appointment date and time.
Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Drug & Alcohol Assessment appointments for P.O. or court purposes have a fee of $160.00. After completing the form, please return to Pam's Place website and go to the 'Donation and PAYMENT PAGE.

Once you have made your payment, please take a
snapshot of the receipt and attach it as part of your reply back to us AT PAMSPLACEONLINE@GMAIL.COM

Please contact us if you have any questions.

313-894-8088

Thank you.

Payment amount is $160.00
Should be Empty:

PPCC DRUG & ALCOHOL ASSESSMENT

GIVE 3 DATES AND TIMES YOU ARE AVAILABLE