Carey Bergeron, LPC

Carey Bergeron & Associates

Licensed Professional Counseling Practice

PAYMENT PORTAL — TERMS & CONDITIONS

Effective: 2026    |    Last Updated: 2026-04-15

IMPORTANT

Please read these Terms and Conditions carefully before using our online payment portal. By submitting a payment through this portal, you acknowledge that you have read, understood, and agree to be bound by these terms in their entirety.

1. Acceptance of Terms

These Payment Portal Terms and Conditions ("Payment Terms") govern your use of the online payment portal ("Portal") provided by Licensed Professional Counselor (LPC) Carey Bergeron, operating under the brand name Carey Bergeron & Associates ("Practice," "we," "our," or "us") on our website located at www.bergerontherapy.com

These Payment Terms apply to all clients and authorized payers who access the Portal to make payments for therapy services rendered by the Practice. Use of this Portal constitutes your full and unconditional acceptance of these terms.

These Payment Terms are incorporated into and supplement our Website Terms of Use, Privacy Policy, and your signed Client Services Agreement. In the event of any conflict between these Payment Terms and your Client Services Agreement regarding financial matters, the Client Services Agreement shall govern.

2. Eligibility and Authorized Use

The Portal is intended for use solely by:

•        Current or prospective clients of Carey Bergeron, LPC. Prospective (new) clients shall not consider the sale final until subsequent completion of intake documentation even though funds have been transferred for payment

•        Authorized third parties (such as parents or legal guardians) paying on behalf of a current client

•        Individuals over the age of 18

You represent and warrant that you are authorized to use the payment method you provide and that all information you submit is accurate, current, and complete. Unauthorized use of this Portal, including payment on behalf of someone without their authorization, is strictly prohibited.

3. Services and Fees

3.1 Session Fees

All fees for therapeutic services are established at the time of intake or as subsequently communicated in writing by the Practice. Your current session rate is documented in your signed Client Services Agreement. The Practice reserves the right to modify fees with a minimum of 30 days written notice.

3.2 Service Schedule and associated Fees

The following general service fee categories may apply. Specific rates for services are set forth on the website and/or in your Client Services Agreement, or as separately agreed by the Practice in writing:

•        Integrative Clinical Therapy

•        Kundalini Reiki

•        Channeled Angelic Readings

•        Quantum Healing Hypnosis

•        Extended Sessions (90 or 120 minutes, where offered – contact us)

•        Group Therapy Sessions (where offered – contact us)

•        Telehealth (Virtual) Sessions

•        Consultation Calls (initial or between-session, as applicable)

Fees for any similar services not listed above, if offered and approved by the Practice on a case-by-case basis, will be communicated in advance and documented in writing.

3.3 Insurance and Out-of-Network Benefits (if/when applicable)

If you are utilizing insurance benefits, your copay, deductible, or coinsurance amount as communicated by your insurer will be collected at the time of service. You are responsible for verifying your benefits and understanding your coverage. The Practice does not guarantee coverage or reimbursement by any insurer.

If you are using out-of-network benefits, payment is due in full at the time of service. We will provide a monthly superbill upon request, which you may submit to your insurance company for possible reimbursement. We make no representations regarding the likelihood or amount of reimbursement.

4. Payment Methods and Processing

4.1 Accepted Payment Methods

The Portal accepts the following forms of payment:

•        All Major Credit Cards (Visa, Mastercard, American Express, Discover, Diners Club, etc.)

•        Major Digital Wallets (Apple Pay, Google Pay, Link by Stripe)

•        ACH Bank Transfer

Personal checks, cash, and money orders are not accepted through the Portal. If you require an alternative payment method (e.g., Venmo), please contact our office directly.

4.2 Payment Processor

Payments are processed by Squarespace through their website hosting platform. By submitting a payment, you also agree to the Payment Processor's terms of service and privacy policy. Squarespace Payments, the native processor, and third-party processors (Stripe) handle transactions according to their own privacy policies and Squarespace Payments Terms (NOTE: It is your responsibility, as user of the payment portal, to identify your chosen payment processor and navigate to their specific privacy policy webpage – we are not responsible for maintaining all third-party payment processor policies). These services, including Squarespace partners Sift and Plaid, securely manage data, with PCI-DSS compliance ensuring sensitive card information is never directly handled by Squarespace. For information on Squarespace’s “Legal & Privacy” contains the Squarespace Payment Terms, access the following webpage: www.squarespace.com/payments-terms.

We do not store your full card number, CVV, or bank account details on our systems. All payment data is encrypted and handled directly by our Payment Processor in accordance with PCI-DSS standards.

4.3 Payment Timing

Unless otherwise agreed in your Client Services Agreement, payment is due by 24 hours prior to the time of service. The Portal may be used to:

•        Pay in advance for scheduled sessions

•        Pay an outstanding balance on your account, where the Practice permits due to client financial hardship (see Section 6.2)

Payments submitted through the Portal are typically applied to your account within one to two business days. If you have questions about how a payment was applied, please contact our billing department at clarity@bergerontherapy.com.

4.4 Payment Confirmation

Upon successful submission of a payment, you will receive an email confirmation to the address associated with your client account. Please retain this confirmation for your records. If you do not receive a confirmation within 24 hours, contact us to verify that your payment was received.

5. Cancellation and Refund Policy

5.1 Session Cancellation

Our cancellation policy is set forth in your Client Services Agreement. Generally:

•        Cancellations made at least 24 hours before a scheduled session will not incur a cancellation fee

•        Late cancellations (less than 24 hours' notice) or no-shows will be charged the full session fee, as specified in your Client Services Agreement

•        Cancellation fees are not reimbursable by insurance and are the sole financial responsibility of the client

To cancel a session, please contact us by phone/email/website-contact-form rather than through the payment portal.

5.2 Refund Policy

All payments for services rendered, or canceled within the 24 hour period prior to your appointment date and time, are final and non-refundable except in the following circumstances:

•        Duplicate payments: If you are charged more than once for the same service, we will refund the duplicate charge within 10 business days

•        Overpayment: If you pay more than the amount owed, the excess will be applied as a credit to your account or refunded upon request

•        Service not rendered: If a session does not occur and a payment has been collected in advance, a full refund or credit will be issued

Refund requests must be submitted in writing to clarity@bergerontherapy.com within 30 days of the transaction. Approved refunds will be returned to the original payment method within 10 business days, subject to your card issuer's processing time.

5.3 Disputed Charges

If you believe a charge is incorrect, please contact us directly before initiating a chargeback with your bank or card issuer. We are committed to resolving billing disputes promptly and fairly. Initiating a chargeback without first contacting us may result in a delay in resolution and could affect your ability to continue using the Portal.

To dispute a charge, contact our billing department at clarity@bergerontherapy.com or +1 (504) 800-3656 within 30 days of the transaction. Please include your name, the date and amount of the charge, and the reason for the dispute.

6. Outstanding Balances and Collections

6.1 Account Balances

You are responsible for making payments to cover scheduled services prior to the date and time of said services. No exceptions will be provided unless explicitly written by the Practice.

The Practice will make good-faith efforts to work with clients experiencing financial hardship. If you are having difficulty meeting your financial obligations, please contact us to discuss Sliding Scale payment options.

6.2 Sliding Scale and Financial Hardship

We offer a limited number of sliding-scale fee slots for clients who demonstrate financial need. Eligibility and rates are determined at the discretion of the Practice. If you are currently on a sliding-scale arrangement, those terms are specified in your Client Services Agreement. Changes to your financial circumstances should be communicated promptly so that your fee may be reassessed.

7. Security of the Payment Portal

7.1 Encryption and PCI Compliance

Our Portal uses industry-standard SSL/TLS encryption to protect data transmitted between your browser and our website. Payment processing is handled by a PCI-DSS Level 1 compliant payment processor. We do not store, process, or transmit full cardholder data on our own servers.

7.2 Your Responsibilities

You are responsible for maintaining the security of your login credentials for the client portal. You agree to:

•        Keep your username and password confidential

•        Log out of the portal when your session is complete, especially on shared devices

•        Notify us immediately if you suspect unauthorized access to your account

•        Use the portal only from secure, trusted networks where possible

We will never ask you for your full payment card number, CVV, or banking credentials via email, phone, or text message.

7.3 Limitation of Liability for Security Incidents

While we implement reasonable security measures, no electronic transmission or storage system is completely secure. We are not liable for any unauthorized access to payment information that results from circumstances beyond our reasonable control, including data breaches at our Payment Processor. We will notify affected clients of any breach of our systems in accordance with applicable law.

8. HSA and FSA Payments (if/when applicable)

Therapy services provided by a licensed mental health professional are generally eligible expenses under Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). However, eligibility is determined by your plan administrator, and we make no guarantees regarding HSA/FSA reimbursability.

If your HSA or FSA card is declined, you are responsible for providing an alternative form of payment at the time of service. We will provide itemized receipts or superbills upon request to assist with FSA/HSA reimbursement claims.

9. Telehealth (Virtual) Payment Considerations

For telehealth sessions, payment is required in advance or at the time of the session via the Portal. Telehealth sessions are subject to the same fee schedule, cancellation policy, and refund terms as in-person sessions unless otherwise specified in your Client Services Agreement.

Telehealth services may be subject to different insurance coverage rules depending on your insurer and state of residence. You are responsible for verifying your telehealth coverage before scheduling.

10. Tax Documentation

Payments for therapy services may be deductible as a medical expense on your federal income tax return, subject to IRS rules and income limitations. We are not tax advisors and encourage you to consult a qualified tax professional regarding deductibility.

We will provide an annual payment summary upon written request, and itemized receipts are available through the portal for each transaction. We do not issue Form 1099 for therapy services to clients.

11. Intellectual Property and Portal Use

The Portal and all associated content, including software, design, text, and logos, are the proprietary property of Carey Bergeron, LPC or its licensors. You are granted a limited, non-exclusive, non-transferable license to access and use the Portal solely for the purpose of making payments for services rendered by the Practice.

You may not attempt to copy, reproduce, reverse-engineer, or tamper with any aspect of the Portal, introduce any malicious code, or use automated tools to access the Portal.

12. Modifications to the Portal and These Terms

We reserve the right to modify, suspend, or discontinue the Portal at any time, with or without notice. We also reserve the right to update these Payment Terms at any time. Updated terms will be posted on this page with a revised effective date.

Your continued use of the Portal following the posting of changes constitutes your acceptance of the revised terms. If you do not agree with any updates, please discontinue use of the Portal and contact us to arrange an alternative payment method.

13. Governing Law and Dispute Resolution

13.1 Governing Law

These Payment Terms are governed by and construed in accordance with the laws of the State of Louisiana without regard to its conflict of law provisions. Any disputes arising under these terms shall be resolved in the courts of Jefferson Parish, Louisiana, and you consent to the personal jurisdiction of such courts.

13.2 Informal Resolution

Before initiating any formal legal action, you agree to first contact us in writing at clarity@bergerontherapy.com and allow us a period of 30 days to resolve the dispute in good faith. This requirement does not apply to emergency injunctive relief.

13.3 Limitation of Liability

To the fullest extent permitted by applicable law, the Practice's total liability to you for any claim arising from your use of the Portal shall not exceed the amount you paid for the specific session or service that is the subject of the dispute.

We are not liable for any indirect, incidental, consequential, or punitive damages arising from your use of the Portal, including but not limited to loss of data, service interruptions, or payment processing errors caused by third parties.

14. HIPAA and Financial Information

Financial records related to your therapy services, including payment history and billing information, are part of your protected health information (PHI) under HIPAA and are treated with the same confidentiality as your clinical records.

We will not share your financial information with third parties except as permitted by HIPAA (e.g., for billing and collections purposes, or as required by law). Our billing staff are trained in HIPAA compliance and are bound by confidentiality agreements.

For more information about how we protect your health and financial information, please refer to our Notice of Privacy Practices and our Website Privacy Policy.

15. Contact Information

For questions about billing, payments, or these Payment Terms, please contact us:

Carey Bergeron, LPC

Carey Bergeron & Associates

Phone: +1 (504) 800-3656

Email: clarity@bergerontherapy.com

Website: www.bergerontherapy.com

For urgent billing concerns, please call our office directly. Email inquiries are typically responded to within a maximum of 2 business days.

By using the payment portal, you confirm that you have read, understood, and agree to these Terms and Conditions in full and all third-party policies referenced herein.

These Terms and Conditions were prepared for a typical clinical therapy practice in consideration of healthcare billing law, consumer protection regulations, and the general best practices for similar service-providers’ payment portals.