Overview
Last updated: November28th, 2023
IMAXWEIGHTLOSS LLC AGREEMENT
This Agreement sets forth the terms of your membership in Weight loss program (“Program”) with Paula Bilica, DO. The Program is designed to provide you with direct personalized medical weight loss services.
INITIAL NOTICES:
NOT HEALTH INSURANCE. THIS AGREEMENT IS NOT HEALTH INSURANCE AND DOES NOT MEET ANY INDIVIDUAL HEALTH INSURANCE MANDATE THAT MAY BE REQUIRED BY FEDERAL LAW, INCLUDING THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT AND COVERS ONLY LIMITED ROUTINE HEALTH CARE SERVICES AS DESIGNATED IN THIS AGREEMENT
BINDING ARBITRATION. THIS CONTRACT CONTAINS A BINDING ARBITRATION PROVISION WHICH MAY BE ENFORCED BY THE PARTIES
1.Once paid, your Membership Fee is non-refundable unless you feel like we have made an error.
2. No Emergency Care; Certain Services and Items Excluded. If you have an emergency, you must dial 911. IMAXWEIGHTLOSS does not treat emergencies. We do not offer primary care medical services or supplements.
3. No Insurance Accepted; Self-Payment Only.
The Program is a direct health care service; it is not health insurance. IMAXWEIGHTLOSS does not participate with or bill commercial health insurance plans or federal health care programs such as Medicare or Medicaid. IMAXWEIGHTLOSS providers may recommend you receive services not offered by IMAXWEIGHTLOSS, but in no event will IMAXWEIGHTLOSS will be responsible for any resulting medical bills. You are solely responsible for payment of all fees for IMAXWEIGHTLOSS.
4. Term and Termination.
Term, IMAXWEIGHTLOSS may, in its sole discretion, not accept this Agreement and return your payment to you. If IMAXWEIGHTLOSS accepts the Agreement, the term of this Agreement will begin on the date IMAXWEIGHTLOSS receives your Membership Fee payment and last for the length of the Membership Term you selected (“Term”). Termination. Either you or IMAXWEIGHTLOSS may terminate this Agreement at any time, with or without cause, upon prior written notice.
5. Electronic Communications.
By providing your email address, you agree to receive electronic communications via email.
6. Privacy and Confidentiality.
IMAXWEIGHTLOSS and its providers will maintain a record of the services they provide you, and will maintain the confidentiality of your medical information in accordance with applicable state law and federal law.
8. Entire Agreement; Amendment.
This Agreement sets forth the entire agreement between the parties with regard to the subject matter hereof and supersedes all prior or contemporaneous oral or written agreements. This Agreement may be amended only in writing signed by all parties. Any communication required or permitted to be sent under this Agreement shall be in writing and sent via electronic mail.
9.Location.
Due to clinician licensing reasons, you have to physically be in the state that your clinician is licensed in during your tele-health or in-person visit. By signing this consent, your are confirming that you will only opt in to care when you are in your state or residence or in one of our locations. Furthermore, you are confirming that your state of residence is one in which we are licensed to treat.