Once this form is submitted, your cancel request will be processed. All requests require a 30 day notice to cancel. Your final bill date will be the 1st of the month after the month you submitted the request. For example if you submit the form in January, February will be your final bill month regardless of when you submitted the request in January.
Rights to Cancel
All Cancellations require a 30 day written notice.
All contract term requirements must be met. If not, you are subject to a termination fee based on your agreement.
Any outstanding balances on your account must be paid prior to submitting this form.
Cancellation will NOT be accepted over the phone.
“ADDITIONAL RIGHTS TO CANCELLATION” You may also cancel this contract for any of the following reasons:
If upon doctor’s written orders you cannot physically receive the services for a period in excess of (3) months.
If you move your residence more than 25 miles from WestFit. PROOF OF RESIDENCE IS REQUIRED.
If you cancel prior to the agreement term you are responsible for the monthly dues on remaining months or a maximum of $350.00. Payment must be paid in full at time of cancel to end contract.