Subscription Service Agreement
For Compounded GLP-1 Injections Services
This Subscription Service Agreement ("Agreement") is entered into by and between Evolution Primary Care ("Provider"), with a principal address at 11264 Boyette Road, Riverview, Florida, and the undersigned patient ("Patient") for the purpose of establishing a subscription plan for Compounded GLP-1 Injections to be administered at home.
1. Subscription Plan Details:
- Subscription Fee: Patient agrees to pay a weekly installment of $105 or $155 for the duration of the subscription period. Cost will depend on which medication patient is on.
- Subscription Duration: The subscription period will last for a total of 4 weeks. Total Subscription Amount: $400 or $600(medication dependant).
2. Payment Terms:
- Payments will be processed automatically every week through the payment method provided by the Patient.
- The Patient authorizes Provider to process weekly payments of $105 or $155 using the provided payment method for the duration of the subscription period.
3. Payment Failure:
- If a payment fails or is not processed due to insufficient funds, incorrect payment information, or other reasons, the subscription will be suspended until the payment issue is resolved.
- A late payment will result in a $29 late fee which will automatically be processed using the card provided for this subscription.
4. Service Suspension:
- In the event of repeated payment failures or unresolved issues, Provider reserves the right to terminate the subscription and discontinue services.
- Upon suspension, the Patient will be notified, and service will remain suspended until the outstanding balance (including late fees) is paid.
5. Termination of Agreement:
- The Patient may terminate this Agreement at any time by providing written notice to the Provider. However, the Patient will still be responsible for the full payment of the subscription fees for the remainder of the 1 month subscription period, even if they terminate the Agreement early. Payments made up to the point of termination are non- refundable.
- Provider reserves the right to terminate this Agreement for non-payment or failure to comply with the terms and conditions outlined herein.
6. Patient Responsibilities:
- The Patient is responsible for keeping their payment information current and ensuring there are sufficient funds in the account to cover the weekly payment.
- The Patient is also responsible for any fees incurred as a result of payment failures and reinstatement requests.
7. Modification of Agreement:
- Provider reserves the right to modify the terms of this Agreement, including the subscription fee, with 30 days' notice to the Patient.
- Any changes will be communicated via the contact information provided by the Patient.
8. Legal Compliance:
- Both parties agree to comply with all applicable laws, regulations, and medical standards in the provision of Compounded GLP-1 Injections services.
9. Indemnification and Limitation of Liability:
- The Patient agrees to indemnify and hold harmless the Provider against any and all claims, losses, or damages arising out of the subscription or use of the services.
- Provider's liability under this Agreement shall be limited to the amount paid by the Patient for the services during the applicable subscription period.
10. Governing Law and Legal Matters:
- This Agreement shall be governed by and construed in accordance with the laws of the State of Florida, without regard to its conflict of law principles. Any legal matters related to this Agreement shall be addressed in Hillsborough County, Florida.
11. Entire Agreement:
- This Agreement constitutes the entire understanding between the parties and supersedes all prior agreements, whether written or oral, relating to the subject matter hereof.