Third-Party Payer Agreement
Effective Date: June 1, 2025
Business Name: Reclaiming Shalom, LLC
Contact: moc.molahsgnimialcer@sirhc
This agreement outlines the responsibilities and expectations of any third party (“Payer”) who agrees to financially support an individual (“Client”) receiving services from Reclaiming Shalom, LLC. It is intended to ensure clarity, mutual understanding, and responsible care for all parties involved.
1. Purpose of Agreement
The Payer agrees to pay for coaching, story work, or group sessions provided to the Client by Reclaiming Shalom, LLC. This agreement applies only to payment and does not grant the Payer access to session content, communication, or confidential information.
2. Client Confidentiality
All sessions and related communications between the Client and Chris Malone of Reclaiming Shalom, LLC are strictly confidential. The Payer will not receive updates, progress reports, session notes, or any information regarding the Client’s participation or content of sessions, unless the Client signs a separate written release of information.
This protects the Client’s autonomy, emotional safety, and the integrity of the work being done.
3. Financial Responsibility
The Payer agrees to the following:
Payment Terms: The Payer will pay for the agreed-upon number of sessions or group participation in advance, unless otherwise arranged in writing.
Method of Payment: Payment will be made via credit/debit card through a secure link provided by Reclaiming Shalom, LLC.
No Refund Policy: All payments are final and non-refundable. Session times are reserved in advance and tailored to the Client. In the case of group participation, the spot is held exclusively for the Client and impacts the group dynamic.
If the Client cancels late or misses a session, the standard cancellation policy applies, and the Payer will still be responsible for the session fee.
4. Voluntary Participation
The Client’s participation in services is voluntary and may be modified or discontinued at any time by the Client. The Payer understands that outcomes cannot be guaranteed and that the success of this work is shaped by the Client’s personal engagement, timing, and readiness.
5. Agreement Duration and Changes
This agreement remains in effect for the duration of the services paid for or until canceled in writing by either party. Any changes to this agreement must be made in writing and agreed upon by all parties.
6. Changes to Terms
Reclaiming Shalom, LLC reserves the right to update these terms at any time. When significant changes are made, you will be notified directly.
7. Questions or Concerns
I welcome your questions and am committed to clarity and mutual respect. If anything in these terms feels confusing or raises concerns, please reach out to moc.molahsgnimialcer@sirhc.