READ THIS CAREFULLY – IT’S IMPORTANT
Before You Proceed: What You MUST Know
🔹 This form is a legal agreement between you and our private practice, as well as between you and your assigned therapist.
🔹 YOU must complete this form yourself. If the client is under 18, a legal guardian or parent must complete it.
🔹 If booking for an under-18 client, they must be aware they are starting therapy and must understand everything in this form.
MEDICAL AID & PAYMENT INFO – DON’T SKIP THIS
We are linked to medical aids, but we do not submit direct claims.
Call your medical aid BEFORE booking to check if they reimburse procedure code 89205.
💡 PMB Applications (Prescribed Minimum Benefits):
- Must be completed by us and submitted to your medical aid BEFORE booking in with us.
- We cannot use PMB approvals from other practices—a new application must be done under our practice number.
💳 Payments:
- NO card payments.
- All payments must be made via EFT minimum 24 hours prior to your session to secure your booking.
- No proof of payment = No booking.
CHOOSE THE RIGHT THERAPY FOR YOU
In-Person Therapy: Available in Stellenberg, Cape Town (between Durbanville & Bellville).
Online Therapy: Available anywhere in South Africa and worldwide.
Our Therapy Options & Rates:
✔️ Tween & Teen Therapy (Grade 4 – 19 yrs) → R650 per 55-min session
✔️ Adult Therapy (20 – 60+ yrs) → R650 per 55-min session
✔️ Couples Therapy → R890 per 60-min session
✔️ Executive Therapy (for CEOs, Directors, Entrepreneurs, and Executives) → R750 per 55-min session
Know Before You Book
✅ YES – We are one of the most affordable private therapy practices in SA.
✅ YES – Our therapy is an eight-week/eight-session process that requires your commitment. (But after your first session, you are not obligated to continue.)
✅ YES – We strictly enforce our 24-hour Cancellation & No-Show Policy.
💡 We have high-risk clients waiting for slots, so if you cancel late or don’t show up, you take a spot someone else desperately needs.
Serious about results? Read our Google Reviews to see if we’re the right fit for you:
👉 https://g.co/kgs/VcWRCo
Still Have Questions?
Email us at info@thetinyroomtherapy.com
Your commitment = Your progress. We are here for you.
