Licensed WAVES CA MEMBER

Our practices maintain autonomy of treatment care while adhering to a shared Ethos.

Member payments are processed monthly. All fees are determined by your membership plan as coordinated with Waves CA LLC. Invoices and receipts are provided directly to you by email. Billing information provided by you will be kept on file to enable regular membership payment processing. You may update billing information at any time with completion of this form.

Cancellation or other changes of membership should be provided in writing to support@wavesca.org.

Please let us know if you have additional questions or needs.

Name

First Name

Last Name

License

Member Payment

Billing Address

Payment Amount

Amount will be processed as recurring payment, monthly