Client Refund Request - Impact Family

REFUND REQUEST PROCESS & FORM

You are entitled to a full refund if you cancel 72 hours before the appointment by clicking the cancelation link in your email confirmation. Please submit a support ticket here if you do not receive an email confirmation.
WATCH Cancel / Reschedule tutorial
You are entitled to a full refund if the counselor does not attend the session after 15 minutes of your scheduled appointment, and you have called their phone number and extension and contacted us through our website contact page.
You are entitled to a refund if you have doctor-verified documentation due to a medical emergency.
If you did not receive a refund notification at the time of cancellation, please submit a refund request form (form right).

"*" indicates required fields

First Name*

Same as the one you used to book your counseling session

Last Name*

Same as the one you used to book your counseling session

Primary Email*

You will receive a copy of this form. Check your spam folder too.

Phone*

Did You Cancel Before The 72 Hour Cancelation Deadline?*

The Date Of Your Appointment*

The Date Of Your Cancellation Request*

Please input the date you canceled by clicking the cancelation link in your email confirmations or send us an email for a refund. Please upload a copy of your email with the timestamp below.

Upload Document /Screenshot or Proof Of Cancellation with Timestamp

Max. file size: 256 MB.

The Amount You Want Refunded*

Amount

If You Cancelled After 72 Hour Deadline, But You Are Still Seeking A Refund, Please Explain Reason(s)

Attachments

Drop files here or

Max. file size: 256 MB.

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