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It specifies an initial minimum of two months, one-time setup and exam fees, and a structure that allows cancellation with 30 days written notice, after which the plan ends the following month and final payments are auto-debited. 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After the 30-day notice is submitted, the plan is discontinued the following month and the last payment is auto-debited.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"Is the Chiropractic Wellness Membership Agreement insurance coverage?",{"text":114,"@type":110},"No. The agreement states it is not insurance, and New Life Chiropractic assumes no risk. It also clarifies that wellness/maintenance services are not covered by Medicare and cannot be billed as such.",{"name":116,"@type":107,"acceptedAnswer":117},"What services are covered under the membership terms?",{"text":118,"@type":110},"The program is for the sole purpose of detection and correction of vertebral subluxation. 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Your plan will be discontinued the following month after your 30-day notice is submitted and your last payment is auto-debited. If canceled, a new setup fee will be required to start a new membership plan.  \n• This Chiropractic Wellness Membership Program is for the sole purpose of detection and correction of vertebral subluxation and is NOTfor the diagnosis or treatment of any symptoms, diseases or conditions.  \n• All memberships are based on monthly auto-debit or annual prepayment by credit card, cash or check.  \n• All memberships are non-transferable.  \n• Fees charged are a retainer fee which allows access to the office during normal business hours.  \n• Members will receive a 100% discount on chiropractic adjustments delivered during normal business hours.  \n• This agreement is not insurance. New Life Chiropractic assumes no risk, monetary or otherwise.  \n• No cash or credit refunds will be given for unused services. It is the Practice Member's sole responsibility to receive care per the chiropractor’s recommendations.  \n• Practice members are eligible for a discounted massage in the office during normal hours for $45, subject to availability.  \n• Chiropractic care may be available while traveling within the USA at another membership practice without charge.  \n• We reserve the right to cancel membership at any time for any reason.  \n• Membership Fee Guarantee: Price protection guarantee –price remains the same for a minimum of 12 months as long as you are a member.  \nPAYMENT TYPE  \n_______ Credit Card Credit Card Type: _____________ Last 4 Digits: _______________  \n_______ ACH (Electronic Check Transfer) Please Attach Voided Check Below3 of4  \nI have read and I understand the above policies. I agree to the terms of Chiropractic Wellness Membership Program. Please charge my selected form of payment above for $_____ on the ___ day of each month beginning _______________.  \nSignature:______________________________________ , Print Name_________________________________Date:_________  \n***ONCE ENTERED INTO THE SYSTEM ALL PAYMENT INFORMATION BELOW THIS LINE WILL BE  \nDESTROYED***  \nCredit/Debit Card Number:  Expiration:  CVV:   \n2 of 4  \nDETAILS OF PATIENT AGREEMENT  \nThis is an Agreement between New Life Chiropractic a Colorado professional corporation, located at 2532 Patterson Road, Suite \\#15, Grand Junction, CO 81505, Wesley Sheader DC, DICCP (Chiropractor) in his capacity as an agent of New Life Chiropractic (NLC), and you, (Patient) .  \nThe Chiropractor, who specializes in chiropractic care, delivers care on behalf of NLC, at the address set forth above. In exchange for certain fees paid by Patient, NLC through its chiropractic care, agrees to provide Patient with the Services described in this Agreement on the terms and conditions set forth in this Agreement.  \nDefinitions  \n1. Patient. A patient is defined as those person or persons for whom the Chiropractor shall provide Services, and who are signatories to, or listed on the documents attached as Appendix 1, and incorporated by reference, to this agreement  \n2. Services. As used in this Agreement, the term Services shall mean a package of services, both chiropractic and non-chiropractic, and certain amenities (collectively “Services”), which are offered","cbCaicSvJ8FFTYfe","https://ap.wps.com/l/cbCaicSvJ8FFTYfe","pdf",171258,"English","# AGREEMENT TERMS\n## Monthly Electronic Transfer and Fees\n## Summary of Terms and Benefits\n## Payment Type\n## Details of Patient Agreement\n## Definitions","[{\"question\":\"How does cancellation work in the Chiropractic Wellness Membership Agreement?\",\"answer\":\"The agreement is month-to-month and may be canceled at any time with a month’s written notice without penalty. After the 30-day notice is submitted, the plan is discontinued the following month and the last payment is auto-debited.\"},{\"question\":\"Is the Chiropractic Wellness Membership Agreement insurance coverage?\",\"answer\":\"No. The agreement states it is not insurance, and New Life Chiropractic assumes no risk. It also clarifies that wellness/maintenance services are not covered by Medicare and cannot be billed as such.\"},{\"question\":\"What services are covered under the membership terms?\",\"answer\":\"The program is for the sole purpose of detection and correction of vertebral subluxation. It explicitly states it is not for the diagnosis or treatment of symptoms, diseases, or conditions.\"}]","Chiropractic Wellness Membership Agreement - 1 of 4 | PDF",1790130910]