DBT PATH New Student Enrollment Form

Month-to-Month Tuition Form

Please take the time to carefully read each item on this form before submitting.

By providing my email address and signing up for this course, I consent to receive class-related emails, which may sometimes contain marketing content, and I understand that I can update my preferences anytime by using the link at the bottom of the emails I receive or through my student portal after logging in. *
I confirm that I am 18 years of age or older or I am a parent or guardian granting permission to a minor to attend this course and make this payment. *
Have you studied with us before and already have a username for our student portal? *
NOTE: After filling out this form, DO NOT CREATE A NEW USERNAME when you land on the page that asks you to create one. Your existing username will be reactivated when we process your enrollment.

Recurring Tuition Billing Authorization and Refund Policy

Tuition Payment Options

Plan: *
Monthly Tuition: *
I understand that my initial tuition payment that I am about to make secures me a spot in this in-demand course, and it is NON-REFUNDABLE, even if I change my mind and drop the course before it starts. The payment will be processed upon submitting this form. *
I understand that tuition automatically recurs every month, at the tuition rate I selected above, and that I will remain continuously enrolled unless I notify DBT Path that I wish to drop the course. (Note: Charges automatically recur every month, on today's date. For example, if today is the 10th, your charge will recur every month on the 10th. Charges will process one day early if you sign up on the 30th or 31st and a given month does not have 30 or 31 days.) *
I understand that there are no refunds on any tuition paid. (If I wish to cancel I will contact DBT Path at least 3 business days prior to when my payment is scheduled, as once it's processed it is non-refundable.)
I understand that a $10 USD fee will be assessed on all late payments to cover administrative costs of additional processing.  *
I understand that the course keeps repeating every 9 months. If I've completed my 9 months and wish to drop, I must submit a drop request or my enrollment and tuition payments will continue.

Terms of Service and Privacy Policy

I have read, understand, and agree to the Terms of Service and Privacy Policy. *

About the Course

I understand that DBT Path does not offer therapy, counseling, or crisis intervention and that I must seek these resources locally, as needed. *
I understand that this class is a psychoeducational, peer-led, holistic, DBT-informed course, is not a replacement for professional psychiatric treatment or services, and that any course I take at DBT Path is not intended to diagnose, treat, or cure any illness or condition. *

I understand that if I drop the course before completing 9-months, I will lose access to the Study Hall Private Forum and Homework Support features of the program. *

I understand that I need to separately purchase the required texts for this course. I'll receive an email with this information when my enrollment is processed.

  • DBT Skills Training Handouts and Worksheets by Dr. Marsha Linehan
  • The Dialectical Behavior Therapy Skills Workbook by Matthew McKay

(Electronic or Hardcopies are both fine. These books will be used for homework assignments between classes. There is no book homework assigned in the first week of class to allow time for you to receive your books. You'll receive an email with a reminder to purchase these books titles shortly after enrollment.)


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Student's Signature

Student's Signature

If you're using a phone, tablet, or another touch-screen device, you can use your finger or stylus to electronically sign. If you're using a computer without a touch screen monitor, use your mouse or stylus.)


Credit Card Holder's Signature

Credit Card Holder's Signature *
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