MIAMI BEACH PEDIATRICS CENTER FOR INTEGRATIVE MEDICINE

CONCIERGE MEMBERSHIP AGREEMENT

This Membership Agreement (\"Agreement\") specifies the terms and conditions between Miami Beach Pediatrics Center for Integrative Medicine (\"Practice\") and the undersigned Member/Patient, under which the Member may participate in the Membership Program. This Agreement shall serve as authorization for treatment, discharge of duties, release of liability, payment, consent for release of medical records/health information, and healthcare/wellness agreement.

Membership Plan Benefits

• Personalized Healthcare
• Continuous access to Doctor from 7:30am till 10pm, and trained medical personnel after hours
• Minimal waiting time for appointments
• Same or next day appointments
• Assistance in handling medical needs while traveling
• Coordination of care with specialists both in and out of state
• Yearly Holistic Workup (labs not included)
• Expedited “Sick Visits,” billed to Member’s Insurance

Term / Renewal / Membership Fee

The Membership Fee is annual and covers a period of 12 months from the date the Member signs. The Membership renews automatically unless cancelled according to the Agreement terms. Failure to pay may result in termination. Practice reserves the right to adjust fees with notice.

Termination

Member may terminate at any time, subject to refund eligibility conditions (inability of Practice to provide services, legal changes, or termination by either party with six months’ notice). Refunds are prorated only in these cases.

This is a preview. Use Full screen to read the complete agreement.