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Membership Hold

Todays Date: November 9, 2025

Member Name:

Phone Number:

Email Address:

Membership Type:

Membership Start Date for Hold (please pick 1st date of corresponding month you would like membership to be frozen): Start Date

Allotted time of freezing my membership (how many months):

We do allow our clients to freeze their memberships a maximum of once a year up to 2 months in total. You must give 10 days written notice by email (info@skinlogicmedspa.com) to freeze your membership or fill out this form 10 days prior to the end of the month. Your membership cannot be frozen past 2 months within the membership year. This specific allotted time cannot be extended or given retroactively.

For Office Use Only

Membership/Plan ID: ____________________________

Membership Freeze Start Date: ____ / ____ / ____

Membership Freeze End Date: ____ / ____ / ____

Processed By: ____________________________

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

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Your email address

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Timestamp

Audit

July 30, 2025 3:01 pm PST

Membership Hold Uploaded by scott smith - scottsm8@gmail.com IP 67.168.123.88

July 30, 2025 3:18 pm PST