AI med consultLicense terms & conditions Agreement for practiceDate License terms and conditions This Order, together with the AI Med Consult End User Agreement, governs your AI Med Consult services. The parties agree to be bound by the terms of the AI Med Consult End User Agreement ("EUA") found in Standard Terms and Conditions. This Order and the EUA together constitute the entire agreement between AI Med Consult and Licensee governing the products and services set out under “The Investment” in the accompanying Proposal and Investment Summary (the “Agreement”), to the exclusion of all other terms. To the extent there is any conflict between this Order and the EUA, this Order shall govern. The signatory below represents that he or she has the authority to bind Licensee to the terms of this Agreement. Licensee is licensed to use those products during the Term. Terms 01 · ServicesAccess to the AI Med Consult online platform. Access to and use of any AI Med Consult Technology is subject to the Module Use limitations set forth below.AI MedConsult · AI MedChat · AI Back Office · AI Prospector · AI Voice · AI Post-Op Nurse 02 · DurationAI Med Consult will provide the Services on a month-to-month basis, beginning on the Effective Date (the “Term”). The Services renew automatically each month unless the Client terminates the Agreement by notifying AI Med Consult in writing, in which case the Services will continue until the end of the month in which the termination notice is received. 03 · Rates & ChargesIn consideration of the Services, Client shall pay AI Med Consult the rates and charges set out under “The Investment” in the accompanying Proposal and Investment Summary (the “Fees”). Client will be billed automatically each month to the credit card on record, beginning on the first day of service and continuing for as long as service is provided. 04 · Special ProvisionsNotwithstanding the foregoing or any provision herein to the contrary, the following terms shall apply to this Proposal and the Terms & Conditions: ROI GUARANTEEAI Med Consult guarantees the client a positive Return on Investment (ROI) within the initial three (3) months after launching our full AI Med Consult product suite on the client’s website and applicable back-office tools. If the client does not achieve a positive ROI within the initial three (3) month period, the client may cancel their subscription and receive a full refund on the monthly subscription fees paid to AI Med Consult. Signatures IN WITNESS WHEREOF, the parties hereto have entered into, executed and delivered this Agreement, to be effective as of the Effective Date. LICENSEE Authorized signature ClearSign with your finger or mouse Title Practice name Effective date AI MED CONSULT, LLC NameBen Stover TitleChief Commercial Officer SignatureAccepted electronically on signing Date AI Med Consult, LLC · St. Petersburg, FL · (866) 225-8017aimedconsult.com
AI med consultCredit card authorization Prepared for practiceDate Credit card authorization Authorizes AI Med Consult, LLC to bill the monthly invoice to the card below. Authorization You authorize a single (1) or regularly scheduled charge to your credit card. You will be charged the amount indicated in your monthly invoice. A receipt for each payment will be provided to you and the charge will appear on your credit card statement. You agree that no prior notification will be provided unless the date or amount changes, in which case you will receive notice from us at least (10) days prior to the payment being collected. Printed name Signature of owner / agentYour signature from the agreement above Date I, ________________________ (Customer), authorize AI Med Consult, LLC (Merchant) to charge my credit card monthly on a recurring basis for the amount due in the invoice sent to the Customer. Billing information Billing address Phone # Email address Payment information CREDIT CARD Card type: Visa AMEX Mastercard Discover Other Card number Expiration date CVVNot stored. Not needed for monthly billing. Card holder ZIP Encrypted on this device before it's sent. Only AI Med Consult's billing team can unlock it. Nothing is charged today. Card number · Expiration date · CVV · Card holder ZIPOur billing team will collect card details with you directly. AI Med Consult, LLC · St. Petersburg, FL · (866) 225-8017aimedconsult.com