Client Change FormClient Change FormCustomer Information - Date / TimeFirst NameLast NameType of Change New Customer Renewal New Credit Card CancellationNew Customer - AddressAddress Line 1Address Line 2CityStateZip CodePhone/MobileEmailRegistration FeeNumber of HoursRate Per HourTotalPayment Plan Yes NoNumber of PaymentsPayment AmountNew Card Type- Select -VisaMasterCardDiscoverAmExCard NumberExpirationCSV/CVV CodeRenewal - Number of HoursRate Per HourTotalPayment Plan Yes NoNumber of PaymentsPayment AmountUse card on file? Yes NoIf you are using the card on file, make sure the card is not expired and they have not moved. You can check for the past card information on Oases in the notes section.New Card Type- Select -VisaMasterCardDiscoverAmExCard NumberExpirationCSV/CVV CodeNew Credit Card - New Card Type- Select -VisaMasterCardDiscoverAmExCard NumberExpirationCSV/CVV CodeRefund - Original Number of HoursNumber of Hours UsedCancellation Fee?Original Rate Per HourNew Rate Per HourContracted TotalAdjusted Total to DragonflyTotal RefundAdditional Instructions - CommentsSubmit Form