We stop bed wetting in 6 to 8 weeks!

Enuresis can be cured!


You may submit the contract online by filling the information out below.

HARGITT HOUSE ENURESIS TREATMENT CENTER CONTRACT

R = Required Information

This Agreement, made and entered into this day   by and between Hargitt House Enuresis Treatment Center, Inc. P.O. Box 130342, The Woodlands, TX 77393-0342, hereinafter referred to as H.H.E.T.C.
Name: R
Address: R
City: R
State/Country: R
Zipcode: R
Phone: R
Email: R
Hereinafter referred to as "Family", is as follows:

H.H.E.T.C. agrees to provide and make available to the "Family" its system of education, motivation and training consisting in part of this provision by H.H.E.T.C. of counseling and related educational and motivational literature.

The "Family" hereby undertakes to keep all information about the Treatment Program confidential and not to disclose the same to any third party or to use same on anyone other than the enuretic, either during the term of this agreement or thereafter, without the express written consent of H.H.E.T.C. The "Family" agrees to fully and faithfully use the equipment and guidance provided by H.H.E.T.C.

Total fee for treatment:    $550.00 United States     $650.00 International

We accept personal checks or payment through our website via Paypal.

Given the personal nature of the subject matter of this Agreement, H.H.E.T.C. represents that it will keep and hold the "Family" and the enuretic confidential and shall not disclose such identity to any person, for any purpose, unless otherwise agreed in writing by the "Family".

The "Family" shall comply with the terms of this Agreement, if enuretic should suffer a relapse of his/her nocturnal enuretic problem within a period of one full year after bedwetting has ceased for a period of twenty-one (21) consecutive nights, H.H.E.T.C. will provide and address the enuretic’s problem again with no additional obligation.

TYPE SIGNATURE:
TYPE TODAY'S DATE:

HARGITT HOUSE ENURESIS TREATMENT CENTER, INC.
PO Box 130342     The Woodlands, TX 77393-0342     FAX: 281-292-4549

Idea - you may want to print this form after you have completed it and before submitting so that you have a copy for yourself

All information is held strictly confidential.

Copyright 2008 All rights reserved
The Hargitt House Foundation
Houston, Texas
(281) 298-2888
email: info@hargitthousefoundation.com