* Required Information Clinical Hours $12 per hour

Acknowledgment of Services and Fees

I understand that all initial sessions are provided free of charge and are intended solely for informational purposes. Participation in any continued services or programs beyond the initial session is entirely voluntary. It will be billed at a rate of $12 per hour, unless otherwise covered by a formal agreement between Kema Health Services and an affiliated institution.

I further understand that the only exception to this fee applies to students currently enrolled at universities that have a direct billing agreement with Kema Health Services, through which program costs may be subsidized or fully covered.

I acknowledge that engaging in any recommended services or programs is my personal choice and that Kema Health Services does not guarantee any specific outcomes. I agree that I am responsible for confirming any costs or commitments prior to participation.

The total Program Fee Structure and Payment Policy

The total program fee is divided into two parts:
  1. 1. Non-refundable Deposit: A $500 deposit is required in advance to reserve your placement. (Unless the school denied your application)
  2. 2. Remaining Balance: The final payment is due once your clinical rotation has been approved by your university and before the rotation commences.

For example, a Walden University student completing a 160-hour rotation would pay a $500 deposit up front, followed by a $1,420 balance, for a total cost of $1,920.

If you choose to return for a subsequent semester with one of our preceptors, the same fee structure applies: a $500 deposit and a $1,420 balance, totaling $1,920.

I consent to the collection, use, storage, and processing of my personal and, where applicable, health-related information, including any data I submit on behalf of others, for the purpose of evaluating or fulfilling my request made through this form. I understand this will be handled in accordance with the Privacy Notice.

Thank you! We’ll get back to you within 1-2 business days.

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