Essential Care Passport Contract

Main Passport Holder Full Name*

First NameLast Name

Email*

example@example.com

I am 18 years of age or older:*

Yes

Essential Care Passport Terms & Agreements

You can use your Essential Care Passport to:

Pay for and receive a 20% discount on the most current cost of Acupuncture, Acupuncture Facial Rejuvenation, Facelift Acupuncture, Specialist Consultations, Nutritional Consultations, and Therapeutic / Orthopedic Bodywork services.
Pay for herb/supplement purchases including custom herbs, diagnostic lab tests, and all other Energy Matters retail with no discount.

Families may share a passport.

You must provide the names of the family members who will be allowed to use your passport.

Your Essential Care Passport cannot be combined with other discounts, except as noted.

Your discount will expire once you have used up the total amount loaded onto your passport, or the money remaining on your passport is less than the cost of your pending invoice. At that point, you may either:

Apply the remaining funds towards renewing your Passport
Or you may receive a credit on your account to use for future services or products.

Your passport number does not expire, as long as you have funds on the passport.

You may choose to auto-renew your passport.

You will be required to sign a different contract to begin the auto-renewal process.

EARLY TERMINATION AND REFUNDS:

You may terminate your passport early. You will receive the original payment amount minus the full-price cost for any services, registrations or kits paid for with your passport.
You must mail written correspondence or send an email electronically to Energy Matters, requesting early termination of your passport.

Mail written correspondence to:
Energy Matters Acupuncture
Attn: Office Manager
4341 Piedmont Ave., 2nd Floor
Oakland, CA 94611

Or Email to: info@energymatterseastbay.com with Subject Header: Attention Office Manager

Termination of your passport will be considered to be on the date we receive your written correspondence or email.
Your passport discount will be discontinued upon termination.
Any refunds will take 2 to 3 weeks to process, will be issued by check, and will be mailed to your address on file.

By entering into this contract you the user acknowledge that you are in agreement and will abide by the terms and conditions of this agreement.

Energy Matters reserves the right to change the terms and wording of the contract, at any time and with short notice. Users will be notified of any changes to the agreement via email.

Energy Matters reserves the right to change, cancel and/or substitute services, classes and terms at any time. In such cases, you will be given ample notice and the opportunity to early terminate your passport.

This contract will be automatically terminated should the Energy Matters services and classes be affected by force majeure to include but not be limited to any natural disasters, fire, etc, and any contractual and legal obligations which may require the business to be relocated or to be shut for an indefinite period.

I have read and understand the Essential Care Passport Terms & Agreements below and agree to its terms.*

Your Initials*

I would like to use my passport to pay for any herbs, supplements, custom herb orders, or other retail available at Energy Matters. I understand that I do not get any discount off of these purchases and that using my passport for these purchases will decrease my funds more quickly.*

YesNo

I would like to extend my passport services to other individuals.*

Yes - List member names belowNo

Full Names of each individual. I give permission to the following individuals to use my passport for their Energy Matters services and herb/supplement purchases.*

Sign up for auto-renewal*

YesNo

TERMS AND CONDITIONS OF ESSENTIAL CARE PASSPORT AUTO RENEW CONTRACT

CONTRACT DURATION AND AUTOMATIC RENEWAL
This contract will automatically renew indefinitely until the user terminates the contract.

SUMMARY OF TERMS

Contract auto renews when total amount on passport is less than the next scheduled service, registration or kit
Automatic renewal indefinitely until terminated
Cancel future auto renewal via email or mail
Please read and agree to the following contract terms and conditions

The user may terminate the auto renewal via phone or email.
By entering into this agreement, the user will provide a valid credit card that they are the account holder of for authorization of this contract and future auto renew payments. If payments fail to authorize for any reason, the user will be notified by email immediately. The user must update their card details/billing information immediately by logging into their account or by phone. If settlement of the due fees are not completed within 10 calendar days of the original failed payment date, a $20 late payment fee will be chargeable.
By entering into this contract the user is in agreement and will abide by the terms and conditions of this agreement.
Energy Matters reserves the right to change the terms and wording of the contract, at any time and with short notice. Users will be notified of any changes to the agreement via email.
Energy Matters reserves the right to change, cancel and/or substitute services and classes at any time.
This contract will be automatically terminated should the Energy Matters services be affected by force majeure to include but not be limited to any natural disasters, fire, etc, and any contractual and legal obligations which may require the services to be relocated or to be shut for an indefinite period.

I have read and understand the Terms and Conditions of Essential Care Passport Auto Renew Contract below.*