Injection Club Terms & Conditions
Notice to Members
Do not sign this agreement before you have read it in its entirety. The member is entitled to a completed copy of this agreement. The member acknowledges that this document is an agreement and will become legally binding upon its acceptance by Quintessence Health and Wellness. The member also understands there will be no refunds issued for any charged member dues and/or fees.
The undersigned member acknowledges receipt of Quintessence Health and Wellness' membership terms and conditions and has read, understands, and agrees to be the terms and conditions as part of this agreement.
Any member, who is under the age of 18, must have a parent or legal guardian co-sign and be present during all office visits. The co-signer, along with the member, agrees to be bound by all terms and conditions of this agreement.
Quintessence Health and Wellness is not responsible for any injury or loss of property to any person while on the premises or participating in Quintessence Health and Wellness services. As a member, I assume full responsibility for services received at Quintessence Health and Wellness and shall indemnify Quintessence Health and Wellness, and its affiliates, agents, and employees against any and all liability arising from services rendered at the time the treatment is performed and hereafter.
Monthly Membership Dues
Membership dues will be automatically charged to member’s bank account/credit card on the 1st or 15th day of every month.
Members that have accrued (banked) units or have purchased dermal filler(s) may
gift any given
or purchased filler the
member has accrued. Members must provide a
selected individual, and quantity
banked units or purchased filler
Quintessence Health and Wellness r
All membership cancellations require a signed Cancellation Letter and must be submitted in person, or the member may request a digital Cancellation Request Form from a Quintessence Health and Wellness staff member. It must be electronically signed, authorizing the cancellation of the member's membership. The Cancellation Request form must be submitted 30 days prior to the next scheduled billing date. If it is not submitted by that time, it will be put into effect the following month. In addition, the member will be required to provide identifying documentation to QH&W for verification and liability purposes.
Enrollment fee is non-refundable, with the exception of members who wish to cancel within the first 30 days of their enrollment date. After which, the enrollment fee is non-refundable. NO EXCEPTIONS. Members that have paid an enrollment fee may cancel membership anytime. Members that were not required to pay an enrollment fee MAY NOT cancel membership within the initial three months after enrollment date.
Members who wish to reinstate a previously canceled membership and/or wish to re-enroll in a new QH&W Injection Membership will be required to pay a new enrollment fee. QH&W reserves the right to offer members that wish to re-enroll a reduced enrollment fee, which will be determined on a case-by- case basis by QH&W administration.
Monthly dues will be automatically withdrawn from the member's bank account via credit/debit card provided by the member at time of enrollment. All Membership Dues are non-refundable
All memberships will automatically renew at the end of the annual term, unless you submit a written request to terminate your membership. During the renewal of your membership, your account will continually be charged the monthly membership fee. If your membership has been paid in full, Quintessence Health and Wellness will contact you regarding a renewal.
Membership Injection Frequency
Frequency of Neuromodulator Injection Appointments may be no sooner than every 3 or 4 months. Members will be allowed to receive cosmetic injections every 3 or 4 months (90 to 120 days), with the unit amount corresponding to the members chosen membership that they have chosen and agreed to.
Banked Unused/Accrued Neuromodulator Units
Unused Botox units will be banked for use for later use. Each membership is alloted a maximum number banked of units. in which the member may bank/save for later use, or if gift to a designated amount of units and a designated recipient that the member provides authorization to receive.
The maximum banked units for memberships are as follows:
(The maximum banked units correlate with the number of units the member has agreed to receive, regardless of the members injection appointment frequency)
Number of Units
20 Units -- Max Bankable Units= 40
30 Units -- Max Bankable Units= 60
40 Units -- Max Bankable Units= 80
50 Units -- Max Bankable Units= 100
60 Units -- Max Bankable Units= 120
Injection Club Member Benefits
Discount on Neuromodulator's
Discount on Unused Fillers
Bank Accrued/ Accrued Units
Gift Unused Units to Family or Friends
Injection Club Dermal Filler Discounts By Selected Membership
30 Units - 15%
40 Units - 20%
50 Units - 20%
60 Units - 20%
Freezing of Membership
Members may freeze membership for minimum of 3 months up to one year. Members who were required to pay enrollment fee may initiate membership freeze at anytime. Members NOT required to pay enrollment fee may NOT initiate membership freeze within the the first 90 days (3 months) of their date of enrollment. Members who wish to freeze their membership must designate freeze duration no less than 3 month minimum. In the case that a member fails to designate a freeze duration, a default of 3 months will be initiated and upheld by the clinic on behalf of the patient.