Polson Medical Fitness Center Membership Cancellation

Please complete and submit this form as notification to cancel your Polson Medical Fitness Center. Please review all the information below regarding our cancellation process before submitting form. You will receive a confirmation email that the form has been submitted. Once reviewed by Member Services you will receive a cancellation confirmation. Please keep all confirmation emails for your record. Thank you. Notification to Cancel Membership Procedure and Policy: In accordance with The Polson Medical Fitness Center Policies and Procedures, I am hereby giving my written notice of cancellation. I understand that membership and billing are not based on usage. Members are responsible for all monthly fees until The Polson Medical Fitness Center receives written notice of your intent to cancel once the initial agreement period has been reached.

By checking the box you are agreeing to the following terms: -This notice must be received 3 business days prior to the first day of the month that the cancellation becomes effective after the membership agreement period ends. - All balances must be paid in full prior to cancellation. - I authorize The Polson Medical Fitness Center to cancel my membership on the date listed below. - I understand The Polson Medical Fitness Center's freeze and leave options, (vacation, medical and occupational) and am declining to take advantage of them. - I understand that if I wish to rejoin at a later date, I will have to pay a new registration fee and execute a new membership agreement.

It must be the first of the month. Cancellations must be must be received 3 business days prior to the first day of the month.

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Please rate us on our quality of our equipment. (1 = poor, 5 = excellent)*
Please rate us on the cleanliness of our facility. (1 = poor, 5 = excellent)*
Please rate us on our staff's friendliness, professionalism & knowledge. (1 = poor, 5 = excellent)*

By typing my name I am hereby giving my written notice of cancellation on the date stated and in accordance with The Polson Medical Fitness Center's Policies and Procedures.