Terms and Conditions

NEW DAWN WEIGHT LOSS, LLC

Practice Policies Effective Date: 5-16-2025
These Practice Policies apply to all patients of New Dawn Weight Loss, LLC (“the Practice”) and  form part of the contractual agreement between you and the Practice. By  signing, you acknowledge you have read, understood, and agree to abide  by these terms.
1) Appointments and Scheduling
1.1 Session Length —  Initial visits are scheduled for approximately 45–60 minutes. Follow-up  visits are typically 15–30 minutes unless otherwise arranged. 1.2  Payment Deadlines — Payment for the onboarding fee or monthly program  fee is due no later than 24 hours prior to your scheduled  appointment/program start date. Failure to make timely payment may  result in loss of your reserved time slot. 1.3 Late Arrival — If you  arrive late, your session will still end at the scheduled time, and you  will be charged for the full appointment.
2) Program Enrollment, Onboarding Fee, and Cancellation
2.1  Onboarding / First Month Payment — Upon enrollment, you will be charged  your onboarding fee (or first month’s payment). This covers  administrative setup, individualized program design, and the ordering of  lab work, devices, and other resources necessary for your care. 2.2  Non-Refundable Once Ordered — Once any devices, laboratory tests, or  program-specific materials have been ordered on your behalf, the  onboarding/first month payment is non-refundable, even if you elect not  to proceed, as these costs are immediately incurred by the Practice. 2.3  Monthly Program Fees — After onboarding, your program operates  month-to-month. If you cancel after onboarding, you will not be billed  for future months, but no pro-rata or partial refund will be issued for  the current month. 2.4 Rescheduling Within a Paid Month — If you need to  cancel or reschedule an appointment within a month you have paid for,  your session will be moved to a later date within that same month at no  additional cost, subject to provider availability. 2.5 Cancellations  Before Ordering — If you cancel before any orders are placed, you may be  eligible for a refund of fees paid, less any documented administrative  or setup costs already incurred. All cancellations must be submitted in  writing.
3) Communication and Availability
3.1 Routine  Communications — You may contact the Practice via the main phone number  or secure messaging through the patient portal/website. We will make  reasonable efforts to respond within one (1) business day. 3.2  Emergencies — The Practice does not provide urgent or emergency care. If  you experience a medical emergency, call 911 or go to the nearest  emergency department. 3.3 Session Preferences — Face-to-face or  telehealth visits are preferred for most medical concerns. Telephone  visits may be offered when appropriate (e.g., during travel or illness).
3.4  Respectful Communication — All communications with the Practice,  including phone calls, emails, secure messages, and in-person  interactions, must remain respectful, professional, and non-threatening.  The Practice maintains a zero-tolerance policy for abusive, harassing,  or aggressive behavior toward providers, staff, or other patients.  Violation of this policy may result in immediate termination of care as  outlined in Section 7.1.
4) Electronic Communications and Telehealth
4.1  Telehealth Definition — Telehealth includes audio, video, secure  messaging, email, fax, and other HIPAA-compliant technologies. 4.2  Voluntary Participation — You may withdraw consent for telehealth at any  time; however, in-person care may only be available if you are  physically located on Moloka‘i, where the Practice maintains its  physical office. 4.3 Security Limitations — The Practice uses  HIPAA-compliant platforms but cannot guarantee 100% security for any  electronic transmission. 4.4 Diagnostic Limitations — You acknowledge  telehealth may limit the provider’s ability to perform a complete  physical exam, which may affect diagnostic accuracy.
5) Device and Supply Shipments
5.1  Direct Fulfillment — The Practice may arrange for devices, monitoring  tools, or other supplies to be shipped directly to you from third-party  vendors. 5.2 Data Disclosure for Orders — The Practice may share limited  personal/health information (e.g., name, address, product  specifications) with vendors solely to fulfill your order, subject to  HIPAA requirements. 5.3 Inspection Upon Receipt — You agree to inspect  all items promptly and notify the Practice within five (5) business days  of any defect, malfunction, or delivery error.
6) Minors
The Practice does not provide care to individuals under the age of 18.
7) Termination of Care
7.1  Provider-Initiated Termination — The Practice may terminate the  patient-provider relationship for repeated non-compliance, missed  appointments without notice, failure to complete required labs,  abusive/disruptive behavior, or non-payment. 7.2 Notice and Referrals —  If care is terminated, the Practice will provide reasonable notice and,  when appropriate, a list of alternative providers. 7.3 Patient-Initiated  Termination — You may terminate care at any time by providing written  notice. Termination does not relieve you of responsibility for payment  for services rendered, items ordered, or the non-refundable  onboarding/first-month payment under Section 2.2.
8) Payment Method Authorization & Chargeback Waiver
8.1  Card/ACH Authorization — You authorize the Practice (and its payment  processors) to store and charge your card or ACH account for: (a) the  onboarding/first month payment; (b) monthly program fees; and (c)  approved add-ons (e.g., additional labs/devices), in accordance with these Policies and your program selection. 8.2 Documentation of Orders —  You acknowledge that vendor confirmations, invoices, tracking numbers,  or lab requisitions constitute proof that orders were placed on your  behalf. 8.3 No Chargebacks (Except Proven Fraud) — You agree not to  dispute, charge back, or reverse any payments made under these Policies  except in the case of proven identity theft or fraud. Any other disputes  must be addressed directly with the Practice under the terms of your  agreement (including the Arbitration provisions in the Master Informed  Consent). 8.4 Reversal Liability — If a payment is reversed contrary to  these terms and an arbitrator/court determines the charge was valid  under this agreement, you agree to promptly reimburse the Practice for  the original amount plus any third-party fees or costs incurred due to  the reversal (to the extent permitted by law). 8.5 Coordination with  Master Consent — Dispute resolution for any payment-related matter shall  be handled pursuant to the Binding Arbitration and Class Action Waiver  in Section 18 of the Master Informed Consent for Care.
9) Acknowledgment and Agreement
By signing below, you confirm that you:

• Have read and understood these Practice Policies;
• Understand the onboarding and monthly fee policies, including the non-refundable provisions in Section 2;
• Authorize charges in accordance with these Policies and Section 8;
• Agree not to dispute or reverse charges except in cases of proven fraud; and
• Accept financial responsibility for all services provided and items ordered on your behalf.

Patient Name: ____________________________________Patient Signature: _______________________________  Date: ____________

Refund & Chargeback Authorization — Separate Initials Required
Please initial each line to indicate your understanding and agreement:
____   I understand that once any labs, devices, or program materials are  ordered on my behalf, my onboarding/first-month payment is  non-refundable (Section 2.2).
____  I understand that after  onboarding, my program is month-to-month; if I cancel, I will not be  billed for future months, but there are no refunds or pro-rations for  the current month (Section 2.3).
____  I authorize New Dawn Weight  Loss, LLC (and its processors) to store and charge my card/ACH for the  onboarding/first month payment, monthly fees, and approved add-ons  (Section 8.1).
____  I agree not to initiate a chargeback or payment  reversal except in cases of proven fraud; all other disputes will be  resolved directly with the Practice under the Master Informed Consent’s  arbitration terms (Sections 8.3 & 8.5).
Patient Initials: _________    Date: __________