Common use of Membership Fee Clause in Contracts

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 000, Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Membership Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 3 (above), subsequently, the Program Member will be billed for the Member Amenities Membership Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Membership Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Concierge Practice and the Program Services, Personalized Care Practice Physician hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Membership Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Membership Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Membership Fees shall be made payable to, and any credit card payments shall be processed by, Signature MDSignatureMD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / Tel: 0 (000) 000-0000 / Fax: 0 (000) 000-0000 xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Membership Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Membership Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Membership Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Concierge Practice and the Program Services, Personalized Care Concierge Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Membership Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Membership Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Membership Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Membership Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Membership Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Membership Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Concierge Practice and the Program Services, Personalized Care Concierge Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Membership Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Membership Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx XxxXxxxxxx Xxxx., Xxxxx 000 Xxxxxx xxx XxxXxxxx Xxxxxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Membership Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Membership Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Membership Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Membership Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Enhanced Cardiac Care Practice and the Program Services, Personalized Enhanced Cardiac Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Membership Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Membership Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Membership Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees I agree to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member I understand I will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees I agree to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees you agree to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 000, Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Membership Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 3 (above), subsequently, the Program Member will be billed for the Member Amenities Membership Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Membership Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Concierge Practice and the Program Services, Personalized Care Practice Physician hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Membership Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Membership Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx XxxXxxxxxx Xxxx., Xxxxx 000 Xxxxxx xxx XxxXxxxx Xxxxxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Membership Fees shall be made payable to, and any credit card payments shall be processed by, Signature MDSignatureMD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx XxxXxxxxxx Xxxx., Xxxxx 000 Xxxxxx xxx Xxx000, Xxxxx Xxxxxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.xxx.xxxxxxxxxXX.xxx

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.xxx.xxxxxxxxxXX.xxx

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MDLEAMC Personalized Care, Inc.PLLC.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 000, Xxxxxx xxx Xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees I agree to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member I understand I will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees I agree to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees you agree to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 000, Xxxxxx xxx Xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees I agree to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member I understand I will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees I agree to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees you agree to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx., Xxxxx 000 000, Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx., Xxxxx 000 000, Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.xxx.xxxxxxxxxXX.xxx

Membership Fee. Program Member agrees to and shall pay the Member Amenities Membership Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 3 (above), subsequently, the Program Member will be billed for the Member Amenities Membership Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Membership Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Concierge Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Membership Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Membership Fees to Signature MDSignatureMD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx Xxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Membership Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees I agree to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member I understand I will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees I agree to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees you agree to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.xxx.xxxxxxxxxXX.xxx

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx XxxXxxxxxx Xxxx., Xxxxx 000 Xxxxxx xxx XxxXxxxx Xxxxxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx XxxXxxxxxx Xxxx., Xxxxx 000 Xxxxxx xxx XxxXxxxx Xxxxxx, XX 00000 / Tel: 0 (000) 000-0000 / Fax: 0 (000) 000-0000 xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / 00000/ (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.xxx.xxxxxxxxxXX.xxx

Membership Fee. Program Member agrees I agree to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member I understand I will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees I agree to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees you agree to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 000, Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.xxx.xxxxxxxxxXX.xxx

Membership Fee. Program Member agrees to and shall pay the Member Amenities Membership Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Membership Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Membership Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Concierge Practice and the Program Services, Personalized Care Practice Physician hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Membership Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Membership Fees to Signature MDSignatureMD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / Tel: 0 (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Membership Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx, XX Xxx 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx XxxXxxxxxx Xxxx., Xxxxx 000 Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.xxx.xxxxxxxxxXX.xxx

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., Inc. 0000 Xxxxxxxxx Xxx, Xxxxx 000 Xxxxxx xxx Xxx Xxx, XX 00000 / Tel: 0 (000) 000-0000 / Fax: 0 (000) 000-0000 xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MD, Inc.

Membership Fee. Program Member agrees to and shall pay the Member Amenities Fee as provided in the Membership Agreement. Unless this Agreement is not renewed, as provided in Section 4 (above), subsequently, the Program Member will be billed for the Member Amenities Fee for each Renewal Year prior to the beginning of each Renewal Year, and the Program Member agrees to pay the invoiced Member Amenities Fee within 30 days after the date of the invoice. In order to facilitate the administration of the Personalized Care Practice and the Program Services, Personalized Care Practice hereby appoints Signature MD, Inc. to perform all billing and collections functions associated with the Member Amenities Fee (but not for medical services covered under any insurance contract, including Medicare). Accordingly, Program Member agrees to submit all payments of Member Amenities Fees to Signature MD, Inc., as follows: Signature MD, Inc., 0000 Xxxxxxxxx Xxx., Xxxxx 000 000, Xxxxxx xxx Xxx, XX 00000 / (000) 000-0000 / xxx.xxxxxxxxxXX.xxx Any checks for payment of the Member Amenities Fees shall be made payable to, and any credit card payments shall be processed by, Signature MDLE&A PC-Solcher, Inc.PLLC.