Online Booking Terms & Conditions Agreement

Premier Life Wellness LLC

Effective Date: 4/16/2026

By scheduling an appointment through our online booking system, you acknowledge that you have read, understood, and agree to the following terms and conditions established by Premier Life Wellness LLC.

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1. Appointment Scheduling

All appointments booked online are requests for services and are subject to confirmation by the Clinic.

Patients agree to:

• Provide accurate and complete personal and medical information.

• Select the correct appointment type based on services needed.

• Arrive on time for scheduled appointments.

• Complete all required intake forms prior to the appointment.

Failure to complete required documentation prior to your appointment may result in rescheduling.

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2. Deposit and Payment Policy

Certain services require a non-refundable deposit at the time of booking.

Deposits:

• Are applied toward the total cost of services.

• Are required to reserve your appointment time.

• Are non-refundable but may be transferable with proper notice (see Cancellation Policy).

Payment for services is due:

• At the time services are rendered, unless otherwise specified.

• Prior to telehealth appointments.

• Prior to laboratory orders, hormone therapy initiation, or peptide therapy, when applicable.

The Clinic accepts:

• Credit Cards

• Debit Cards

• HSA/FSA cards (where applicable)

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3. Cancellation and Rescheduling Policy

We require at least 24 hours notice to cancel or reschedule an appointment.

If proper notice is not provided:

• The deposit may be forfeited.

• A late cancellation fee of $25.00 may be charged.

• Missed appointments (“No-Shows”) may incur a No-Show Fee of $25.00.

Repeated missed appointments may result in:

• Restrictions on future scheduling

• Requirement of full prepayment before booking future appointments

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4. Late Arrival Policy

Patients arriving late may:

• Have their appointment shortened to maintain schedule flow, or

• Be required to reschedule

Late arrivals exceeding [10–15 minutes] may be considered a missed appointment and subject to the No-Show Fee.

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5. Telehealth Appointment Policy

By booking telehealth services, you agree to:

• Participate in telehealth services using a secure internet connection.

• Be physically located in a state where the provider is licensed at the time of the appointment.

• Ensure privacy during the appointment.

Technical issues on the patient’s end that prevent completion of the visit may result in rescheduling and possible fees.

Telehealth services are subject to:

• State regulations

• Provider licensure requirements

• Medical appropriateness

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6. Laboratory and Diagnostic Testing Policy

Certain services require laboratory testing prior to treatment initiation or follow-up care.

Patients acknowledge:

• Laboratory fees may be separate from appointment fees.

• Lab services will be billed directly to the patient by Premier Life Wellness.

• The Clinic does not accept insurance. All cash rates apply.

Failure to complete required labs may delay treatment.

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7. Hormone Therapy and Peptide Services

Services related to:

• Bioidentical Hormone Replacement Therapy (BHRT)

• Peptide Optimization

• Weight Loss Programs

• Functional Medicine Programs

Require:

• Medical evaluation

• Laboratory review

• Provider approval

Treatment is not guaranteed and is based on medical necessity and clinical judgment.

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8. Refund Policy

Due to the nature of medical services:

• Consultation fees are non-refundable once services have been rendered.

• Medication, supplements, peptides, and compounded prescriptions are non-refundable once dispensed.

• Packages and prepaid services may be subject to specific refund terms outlined separately.

Unused services in packages may be transferable but not refundable unless otherwise specified.

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9. Insurance Disclaimer

Premier Life Wellness LLC operates as a cash-based practice.

Patients acknowledge:

• The Clinic does not bill insurance.

• Patients are responsible for all charges.

• Receipts may be provided for possible reimbursement (if applicable).

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10. Medical Disclaimer

Booking an appointment does not establish a provider-patient relationship until:

• The patient is evaluated by a licensed provider, and

• Care is formally initiated.

All medical recommendations:

• Are based on clinical evaluation.

• May vary by individual.

• Require patient compliance and follow-up.

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11. Communication Consent

By booking online, you consent to receive:

• Appointment reminders

• Scheduling notifications

• Administrative messages

Via:

• Email

• SMS/Text Message

• Phone calls

Standard messaging rates may apply.

You may opt out of marketing communications at any time.

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12. Privacy and HIPAA Compliance

[Clinic Name] complies with all applicable HIPAA privacy regulations.

By booking online, you acknowledge:

• Your information will be stored securely.

• Your personal health information will be handled according to privacy laws.

A full Notice of Privacy Practices is available upon request.

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13. Minor Patients Policy

Patients under the age of 18 must. Most services are not offered to minor patients.

• Be accompanied by a parent or legal guardian.

• Have signed consent forms prior to treatment.

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14. Right to Refuse Service

The Clinic reserves the right to:

• Refuse or discontinue services

• Reschedule appointments

• Modify treatment plans

Based on:

• Medical appropriateness

• Safety concerns

• Non-compliance

• Disruptive or inappropriate behavior

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15. Agreement to Terms

By scheduling an appointment through our online booking system, you acknowledge and agree to:

• All policies listed above

• Financial responsibility for services

• Compliance with clinic policies