Pivot Additional Session Payment Form - 3 Hours Clinical Practitioner

Session – 3 Hours

Pivot Additional Session Payment Form - 3 Hours Clinical Practitioner

Billing Details

First Name(Required)

Last Name(Required)

Email(Required)

Phone Number(Required)

Company

Billing Address

Payment Details

Name of the person receiving services

Additional Session(Required)

Price:

Total

(incl $67.50 GST)

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Note: You will be redirected to Windcave’s processing page (a secure third party website).

Payment will be processed securely by WindCave. Accepted payment methods are Visa and Mastercard credit and debit cards, and Account2Account payments through selected banks. Amounts displayed is in New Zealand dollars and are inclusive of GST. Your statement will show payment made to NZ Health Group.

Pivot Additional Session Payment Form - 3 Hours Clinical Practitioner