Pay Deposit To Hold Scheduled Appointment

Thank you for scheduling a session with Tampa Bay Hypno-Therapy, LLC. It is our sincere intention to be at our agreed location, at the agreed upon time and day, and we assume that is your intention as well.

You may make the required non-refundable $100.00 deposit to hold your first appointment, which of course, is applied to total cost of that first session. Unless other arrangements have been made, appointments without a deposit may not be honored.

To Make A Payment, Please Complete The Form Below

Please complete the fields on this Secure Credit Card
Authorization Form then click on Submit.
Thank You.

Secure Your Appointment with Payment

Please complete the form below to hold your scheduled appointment. * indicates required field.

I, the above-named authorized credit card user, give Tampa Bay Hypnotherapy and its representative express authorization to charge my credit card for the purposes detailed above. I understand that this form constitutes a legally binding contract and that by affixing my signature to this form, I will be held responsible for all agreed upon (as stated above) charges as well as any and all collection and legal fees. This credit card is authorized for only the charges noted above. By signing this "Credit Card Authorization" form, I/my organization acknowledge receipt and understanding of its contents, including its "Explicit Authorization" clause.

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Contact Info


Tampa Bay HypnoTherapy
2961 1st Avenue North, Suite B
St. Petersburg, Florida 33713


(727) 543-7556


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