Term Form Timing Requirements. All Term Forms must be received by Practice no later than thirty (30) days prior to Patient’s next credit/debit auto-processing date. Patient shall be responsible for verifying with Practice that his or her Term Form was received by Practice 30 days in advance of Patient’s next auto billing date. Term Forms submitted within the 30-day billing cycle will result in a final Membership Fee auto payment, enabling Patient to utilize the Program Services for another 30 days. No refund will be issued once an auto payment is made.
