Common use of Termination by Patient Clause in Contracts

Termination by Patient. 1 I understand that I may cancel this Agreement at any time by sending Evolve written notice: (a) stating that I wish to cease using Evolve for my medical services, and (b) requesting that a copy of my medical records be sent to either another physician or directly to me. Please note a minimum of 3 business days processing time is necessary to affect the cancellation. 2 I understand that after cancellation, Evolve will no longer be able to prescribe or continue any prescriptions which I may have been receiving on a long-term basis and it is further understood that PRIOR to cancelling my contract, I will establish treatment with and transfer care to my new Primary Care provider. 3 Budget billing is our monthly plan. I understand that if I terminate this Agreement within the first six months of membership after utilizing the Services in any way, I will pay Evolve a total of six months of membership fees in addition to any other Services costs. This is because I understand that Evolve does not place limits on the amount of care that I may receive from it per month. Accordingly, I may, based on the status of my health when joining Evolve, receive a multitude of services in a very short period of time. As a result, I understand and agree that it is only fair for Evolve to receive a total of six months of membership fees despite my terminating the contract earlier than six months into my membership. Alternatively, I may opt to pay for any services received in the first 6 months based on the current non-member (urgent care) rate.

Appears in 4 contracts

Samples: Membership Agreement, Membership Agreement, Membership Agreement

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Termination by Patient. 1 I understand that I may cancel this Agreement at any time by sending Evolve written notice: (a) stating that I wish to cease using Evolve for my medical services, and (b) requesting that a copy of my medical records be sent to either another physician or directly to me. Please note a minimum of 3 business days processing time is necessary to affect the cancellation. 2 I understand that after cancellation, Evolve will no longer be able to prescribe or continue any prescriptions which I may have been receiving on a long-term basis and it is further understood that PRIOR to cancelling my contract, I will establish treatment with and transfer care to my new Primary Care provider. . 3 Budget billing is our monthly plan. I understand that if I terminate this Agreement within the first six months of membership after utilizing the Services in any way, I will pay Evolve a total of six months of membership fees in addition to any other Services costs. This is because I understand that Evolve does not place limits on the amount of care that I may receive from it per month. Accordingly, I may, based on the status of my health when joining Evolve, receive a multitude of services in a very short period of time. As a result, I understand and agree that it is only fair for Evolve to receive a total of six months of membership fees despite my terminating the contract earlier than six months into my membership. Alternatively, I may opt to pay for any services received in the first 6 months based on the current non-member (urgent care) rate.

Appears in 1 contract

Samples: Membership Agreement

Termination by Patient. 1 I understand that I may cancel this Agreement at any time by sending Evolve IHNC written notice: (a) stating that I wish to cease using Evolve IHNC for my medical services, and (b) requesting that a copy of my medical records be sent to either another physician or directly to me. Please note a minimum of 3 three (3) business days processing time is necessary to affect the cancellation. 2 . I understand that after cancellation, Evolve IHNC will no longer be able to prescribe or continue any prescriptions which I may have been receiving on a long-term basis and it is further understood that PRIOR to cancelling my contract, I will establish treatment with and transfer care to my new Primary Care provider. 3 Budget billing is our monthly plan. I understand that if I terminate this Agreement within the first six (6) months of membership after utilizing the Services in any way, I will pay Evolve IHNC a total of six (6) months of membership fees in addition to any other Services costs. This is because I understand that Evolve IHNC does not place limits on the amount of care that I may receive from it per month. Accordingly, I may, based on the status of my health when joining EvolveIHNC, receive a multitude of services in a very short period of time. As a result, I understand and agree that it is only fair for Evolve IHNC to receive a total of six (6) months of membership fees despite my terminating the contract earlier than six (6) months into my membership. Alternatively, I may opt to pay for any services received in the first 6 six (6) months based on the current non-member (urgent care) rate.

Appears in 1 contract

Samples: Membership Agreement

Termination by Patient. 1 1. I understand that I may cancel this Agreement at any time by sending Evolve IHNC written notice: (a) stating that I wish to cease using Evolve IHNC for my medical services, and (b) requesting that a copy of my medical records be sent to either another physician or directly to me. Please note a minimum of 3 three (3) business days processing time is necessary to affect the cancellation. 2 2. I understand that after cancellation, Evolve IHNC will no longer be able to prescribe or continue any prescriptions which I may have been receiving on a long-term basis and it is further understood that PRIOR to cancelling my contract, I will establish treatment with and transfer care to my new Primary Care provider. 3. 3 Budget billing is our monthly plan. I understand that if I terminate this Agreement within the first six (6) months of membership after utilizing the Services in any way, I will pay Evolve IHNC a total of six (6) months of membership fees in addition to any other Services costs. This is because I understand that Evolve IHNC does not place limits on the amount of care that I may receive from it per month. Accordingly, I may, based on the status of my health when joining EvolveIHNC, receive a multitude of services in a very short period of time. As a result, I understand and agree that it is only fair for Evolve IHNC to receive a total of six (6) months of membership fees despite my terminating the contract earlier than six (6) months into my membership. Alternatively, I may opt to pay for any services received in the first 6 six (6) months based on the current non-member (urgent care) rate.

Appears in 1 contract

Samples: Membership Agreement

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Termination by Patient. 1 1. I understand that I may cancel this Agreement at any time by sending Evolve written notice: (a) stating that I wish to cease using Evolve for my medical services, and (b) requesting that a copy of my medical records be sent to either another physician or directly to me. Please note a minimum of 3 business days processing time is necessary to affect the cancellation. 2 2. I understand that after cancellation, Evolve will no longer be able to prescribe or continue any prescriptions which I may have been receiving on a long-term basis and it is further understood that PRIOR to cancelling canceling my contract, I will establish treatment with with, and transfer care to my new Primary Care primary care provider. 3. 3 Budget billing is our monthly plan. I understand that if I terminate this Agreement within the first six months of membership after utilizing the Services in any way, I will pay Evolve a total of six months of membership fees in addition to any other Services costs. This is because I understand that Evolve does not place limits on the amount of care that I may receive from it per month. Accordingly, I may, based on the status of my health when joining Evolve, receive a multitude of services in a very short period of time. As a result, I understand and agree that it is only fair for Evolve to receive a total of six months of membership fees despite my terminating the contract earlier than six months into my membership. Alternatively, I may opt to pay for any services received in the first 6 six months based on the current non-member (urgent care) rate.

Appears in 1 contract

Samples: Membership Agreement

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