MEMBERSHIP AGREEMENT GUIDELINES
We are excited to be working with you on your wellness goals and tailoring your program to fit your needs. As a unique integrative health and wellness organization with our referring Physician Dr. Michael Repik, Age Management Institute will be partnering with you to help you make positive changes in your life that you feel will help you live life to the fullest.
You have chosen to enter into a membership program with AMI Santa Barbara. This is a program tailored to your specific goals and is important for you to keep in contact with the AMI Team to ensure you the best care for your treatment plan. Your monthly membership includes the following;
All extra office visits with doctor and staff, i.e. Body Composition testing using In-Body.
Costs for All Approved Medications Prescribed by Physician
Ground Shipping Charges 7-10 days (All Medication Shipped to Your Door)
All Syringes and Medical Supplies needed
Access to “Fullscript” our online dispensary for trusted pharmaceutical grade supplements at
doctors wholesale pricing.
24/7 Phone Support, Email Notifications and Reminders for Appointments
Full Access to all AMI dietary, supplement, nutrition education and services
Concierge Treatment with ongoing coaching and guidance
All Subsequent Related Doctor Visits
Specialty referral service
Secure HIPPA Compliant Online Medical Record Management
*No additional consultation fees. | * No inconvenient weekly office visits for injections. | **This service does not include 24 hour on-call coverage for emergencies or hospitalization. | ** Membership does not include your Initial Consultation with the Doctor nor does it cover your Lab Assays
All medications will be shipped directly to you from the pharmacy via ground shipping (7-10 business days) which is included in your membership. When you receive the medications be sure to read the instructions provided from the pharmacist and dosing prescription. The staff at AMI are also available to help you go over dosing and administration.
* It is important that you follow the Doctor prescribed dosing protocol that is written on the medications from the pharmacy. The pharmacy will not refill the prescription early if you are taking more of a dose than the doctor has prescribed.
*If medication is lost, confiscated and/or damaged, you are responsible for the pharmacies restocking cost and for the price of the replacement of medication.
PRESCRIPTION REFILL REQUESTS
For prescription refills, we ask that you contact our office 7-10 days before running out of your medication, for your medication refill request. Please plan ahead to avoid any interruptions in your medications.
Cash, checks or credit cards are all accepted methods of payment for services. When you completed your membership agreement, we request a credit card on file. If additional lab tests, follow up consultations, or supplements are required, the appropriate fees will be billed to your credit card on file unless otherwise specified.
If you prefer to expedite your Prescription from the pharmacy you can pay the additional $30 for 2 Day Priority Shipping, or $50 for Overnight Service. *Please note that all prescriptions require a 2 day pharmacy processing time. If you need a rush on your prescription there is a $10 charge.
There is no sales tax in the state of California for medications, however you may be subject to a 4% pharmacy/merchant fee.
RETURNS / REFUNDS
Failure to follow the AMI Protocol’s for your membership program does not relieve you of the obligation to pay the full tuition for the program or phase in which you are currently enrolled. Over the counter supplements purchased from AMI may be returned for a refund or exchange if in original condition and unopened or unused within 14 days of purchase.
FREEZE AND/OR CANCELLATION
We understand that circumstances may occur during your membership and you have 2 options in what to do with your membership. To cancel or to freeze the account both of which require a written notice, delivered to AMI Santa Barbara by mail, email or in person at least 30 days prior to the cancellation/freeze date desired.
Cancellation: Your membership agreement with AMI may be canceled at any time. Once the 30 day written cancellation notice has been processed, billing will be stopped and your chart will be closed. In order to get back into any program with AMI, you will have to rejoin as a new patient with a face to face consult with our Physician, including and not limited to a physical exam and new labs.
*NOTE: The cancellation date will depend on the most current refill date of your prescription. Any or all Membership Discounts will be discontinued upon cancellation request.
Freeze: A membership with AMI may be placed on hold at any time of up to 90 days for $30/month, limited to 2 freezes per year. If you, the membership, wishes to freeze the agreement you may do so by sending as long as a prescription hasn’t been filled within the 30 days you can roll your membership program over to a freeze status. If a prescription has been filled within the 30 days of the written request, your freeze will start the day after your billing cycle.
AMI Santa Barbara is committed to protecting the privacy of our clients. We make every effort to ensure that the information you share with us is recorded accurately, retained securely and used only according to your wishes. If you have any questions about how your personal information is handled or distributed, please contact our office.
AMI has recently partnered with a trusted pharmaceutical grade online supplement dispensary, Fullscript. Fullscript is the safest and most convenient way to purchase professional-grade supplement brands and products.
Supplement products that have been recommended by our Physician will arrive at your door quickly and in excellent condition. They take every precaution to ensure that temperature-senstitive products are stored and shipped according to the manufacturers specifications. We are thrilled to offer their service to you, as they are 100% in alignment with the level of client care and support as we are here at AMI.
A limited recommended over the counter supplements are available for purchased at our Age Management Institute office. You are not obligated to purchase supplements from AMI.