Plan Benefit
Subscription Agreement
I, James Jones, authorize Callondoc.com to charge an initial fee of $50 and recurring subscription fee of $50 to my payment card every 90 days . I understand that the recurring subscription fees are non-refundable and this authorization will remain in effect, and accept the responsibility for all recurring charges until I cancel the agreement in writing.
Financial Responsibility Agreement
I, James Jones, certify that I am the authorized user of this payment card and agree that I will pay for this purchase in accordance with the issuing bank cardholder agreement.
I, James Jones, agree to notify Callondoc.com of any changes to my payment information a few days prior to the next billing date.
I, James Jones, agree not to dispute or chargeback all authorized payments. In the event that I initiate a merchant dispute and/or chargeback, I authorize Callondoc.com to provide this agreement and any other supporting documentation to my financial institution. I understand that filing a chargeback or other payment dispute is considered to be a violation of this agreement and may be subject to collection action that may result in a collection fee of not less than $150, in addition to any fees that may be imposed by the outside collection agency or its legal representation.
Cancelation Policy
I, James Jones, understand that medical services and prescription refills will be interrupted or immediately terminated if my recurring payments are interrupted or canceled. You can cancel anytime on your patient dashboard or in writing via email to
[email protected]
Amount: $50 Charged Today And Every 90 DAYS
Start Date: MM/DD/YYYY
Next Billing Date: MM/DD/YYYY
e-Signature: 
By clicking on subscribe now, I acknowledge that I have read Plan Benefits and agree with the Subscription Agreement, Financial Responsibility Agreement and Cancelation Policy.