Membership Cancellation


Todays Date: March 27, 2025

Member Name:  

Phone Number:  

Email Address:  

By sharing your reason for cancellation, you help us identify areas to grow and serve our clients better:  

Membership Type:  

Membership Start Date:    

As stated in our Membership Agreement our cancellation policy asks for 10 days written notice before your membership cancellation. If the date signed  is less then 10 days before the end of the month your membership cancellation will be the following month from the date signed. 

Requested Cancellation Date:

Please choose the last day of the month that you would like to be charged.  Ex. 11/30/24  would mean your last auto billing would be on 11/1/24.

Terms and Conditions of Membership Cancellation:

  1. Early Termination Fee: If your cancellation request is before your one year membership start date, an early termination fee will apply:
    • Gold Membership: $295
    • Platinum Membership: $575

For Office Use Only

Membership/Plan ID: ____________________________

Membership Start Date: ____ / ____ / ____

Membership End Date: ____ / ____ / ____

Cancellation Processed By: ____________________________

Final Confirmation: By signing below, I confirm my request to cancel my Skinlogic Med Spa membership as of the specified date and agree to the terms and conditions listed above.

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Membership Cancellation
lock iconUnique Document ID: a61a6beaedfb6122bc6bc177e7b7412c503a09ae
Timestamp Audit
November 2, 2024 3:29 pm PDTMembership Cancellation Uploaded by scott smith - scottsm8@gmail.com IP 67.168.123.88
November 30, 2024 12:04 pm PDTMembership Cancellation - infossc2001@gmail.com added by scott smith - scottsm8@gmail.com as a CC'd Recipient Ip: 67.168.123.88
December 3, 2024 3:38 am PDTMembership Cancellation - infossc2001@gmail.com added by scott smith - scottsm8@gmail.com as a CC'd Recipient Ip: 98.203.141.236
December 3, 2024 2:30 pm PDTMembership Cancellation - infossc2001@gmail.com added by scott smith - scottsm8@gmail.com as a CC'd Recipient Ip: 67.168.123.88
January 18, 2025 4:30 pm PDTMembership Cancellation - infossc2001@gmail.com added by scott smith - scottsm8@gmail.com as a CC'd Recipient Ip: 212.102.46.196
January 18, 2025 4:33 pm PDTMembership Cancellation - infossc2001@gmail.com added by scott smith - scottsm8@gmail.com as a CC'd Recipient Ip: 212.102.46.196
January 18, 2025 4:34 pm PDTMembership Cancellation - infossc2001@gmail.com added by scott smith - scottsm8@gmail.com as a CC'd Recipient Ip: 212.102.46.196
February 5, 2025 3:06 pm PDTMembership Cancellation - infossc2001@gmail.com added by scott smith - scottsm8@gmail.com as a CC'd Recipient Ip: 67.168.123.88