Membership Cancellation Request Form

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We're sad to see you go! Please fill out this short form to submit your cancellation request and to let us know what you liked, didn't like, and how we can improve for the future.

Email *

Your First and Last Name: *

Today's Date: *

YYYY

Per the terms of our membership contract, we require at least a 3 month commitment and 15 days notice to cancel your membership. This means that if you are requesting cancellation within 15 days of your next billing date, you may be billed one final time before the contract terminates. If you're requesting cancellation 15 days or more before your next billing date, you will not be billed again. If you are still within the 3 month minimum commitment period, your membership will bill up to 3 times after you finalize your cancellation request and then terminate after the final billing date. You will have until your contract termination date, which will be sent to you in an email after your request has been processed, to use any remaining massage tokens. Your membership discounts will continue to be in effect until your contract termination date. *

I understand

Required

Why are you cancelling your membership? *

No longer need it

Moving

Illness/injury

Financial

Did not meet my needs

Switching to another practice

Quality was less than expected

Ease of use was less than expected

Customer service was less than expected

Other:

Required

Overall, how satisfied were you with your Well Into Life membership?

Would you recommend our membership / services to colleagues or friends?

Is there anything we can do to improve our membership / services?

If there's anything else you'd like to share, please let us know here:

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