Myo DIY Services Contract
Thank you for signing up for Myo DIY. We look forward to providing you the highest standard of care!
It is your obligation to read this contract thoroughly before continuing.
The following is a contractual, binding agreement between:
, hereafter called the Client, and Myo DIY.
Myo DIY is a muscle strengthening and informational education program. As such, it requires the Client’s active participation and dedication in order to achieve the best possible results. As consistency is key to success, it is highly recommended that sessions are scheduled once a week and no longer than 15 days between sessions unless otherwise directed. Session(s) will be scheduled sequentially at the end of each meeting. If the Client does not wish to schedule the next appointment at that time, it is the Client’s responsibility to contact Myo DIY to schedule the next session.
When signing this contract, you, the Client, are committing to:
· Completion of all weekly assignments
· Attending sessions in a timely manner and scheduling sessions within the suggested timeline
· Automatic payments
· Contacting other healthcare professionals directly, if requested/required
· Contacting Client’s insurance of their own accord, if desired.
SERVICES
Myo DIY and its employees are strictly Educational Consultants in the matter of the tongue, face, mouth, and neck areas.
-The Client acknowledges and understands that the programs and services offered by Myo DIY and any of its employees are educational programs only, and that Myo DIY nor any of its employees do not represent or consider themselves as licensed medical or healthcare professionals of any kind, nor do they make, give, sell, or distribute diagnoses, treatments, therapies, examinations, or interventions of any kind.
-The Client acknowledges that the views, opinions, and statements of Myo DIY and any of its employees are opinions only, and cannot be construed as diagnoses, treatments, therapies, examinations, or interventions of any kind.
-The Client acknowledges that it is their own, personal duty to seek out any medical advice from a licensed medical or healthcare practitioner prior-to, during, and after any sessions or programs, and will not hold Myo DIY nor any of its employees responsible if they do not do so.
- The Client acknowledges that Myo DIY nor any of its employees can guarantee any specific result or improvement from surgery or program(s). Client also acknowledges that the Client’s daily participation and commitment outside of live sessions is crucial to facilitating or encouraging changes, and therefore understands and accepts this personal responsibility and commitment.
PAYMENTS
All payments are made automatically.
By signing this contract, the Client agrees to an automatic bank draft, credit card, or debit card payment as selected.
- The first payment will be initiated immediately upon the signing of this contract, prior to the first session.
- Once initiated, payments are billed regularly by calendar week- regardless of appointment date. Therefore, full payment for programs and/or packages may be paid before all package sessions have taken place. Once total program payment is made in full, automatic payments will stop.
- In order to encourage continued and consistent attendance, no partial refunds will be given for unused sessions. Inactivity of 4 weeks or more that is not specifically directed/requested by Myo DIY will result in a closed account, and any resumption will require a new package purchase and new program start.
- Additional visits not included in package fees may be necessary.
- Client acknowledges that any payments, charges, or fees for a tongue-tie release procedure, lip-tie release procedure, or any other referral and/or insurance submission is the responsibility of the Client, and is not included in the fees paid to Myo DIY.
- Fees are based on the July 2024 fee schedule. Fees are subject to increase and change.
CANCELLATIONS
Sessions cancelled and/or rescheduled within 24 hours are subject to a fee of $50.
- Clients are required to attend sessions in a timely manner; tardiness of 10 mins or later will be considered a missed appointment and charged the full fee/session duration.
- If, for any reason, Myo DIY or any of its affiliates are running late, contact to Client will be made via one of the following: Zoom room chat, text message, and/or email.
- Any reschedule initiated by Myo DIY at any time will be free of charge, and not taken out of package total.
RELATED SURGERY
If Client is pursuing tongue tie release surgery:
- A minimum of 5 Live zoom sessions are required both prior-to and post-surgery (10 total), at frequency stipulation of Myo DIY.
- Myo DIY and any of its employees reserve the right to directly advise Client’s release provider against allowing Client to pursue surgery at any point, if Myo DIY or any of its employees feel Client is not adequately prepared for surgery.
- Clients pursuing a tongue tie release must complete a contract of 10 sessions total once live zoom sessions begin. If Client wishes to discontinue this contract at any point after live zoom session(s) begin, client will be charged full remainder of contract total, or be subject to a lesser 'cancelation fee', as determined by Myo DIY.
- In order to ensure Client's best interests and facilitate the best possible healing, no refunds or cancellations will be given for unused sessions to Clients who have scheduled and/or completed a tongue tie release surgery. Once surgery is completed, Client is required to complete payment in full package and/or program.
- The Client acknowledges that Myo DIY nor any of its employees can guarantee any specific result or improvement from surgery or program(s).
- Client acknowledges that the Client’s daily participation and commitment outside of live sessions post-surgery is absolutely crucial to the healing process, and therefore understands and accepts this personal responsibility and commitment.
- Client acknowledges that any payments, charges, or fees for a tongue-tie release procedure, lip-tie release procedure, or any other referral and/or insurance submission is the responsibility of the Client, and is not included in the fees paid to Myo DIY.
INSURANCE
Myo DIY nor its employees do not bill, contact, and/or submit to any insurances directly.
- Therefore, if Client is desirous, all insurance estimates, reimburses, submissions, changes, corrections, and any other additional information or documentation must be created, facilitated, and submitted by the Client directly to Client’s insurance.
REFERRALS
Photo and video communication between Myo DIY and other health providers and/or practitioners is critical for your success. We strive to always abide by HIPPA privacy laws and to protect your identity wherever possible.
- Client hereby grants and authorizes Myo DIY the right to take, edit, alter, copy, exhibit, publish, distribute, and make use of any and all pictures and videos taken to be used in and/or for any medical communications between practitioners. This authorization extends to all languages, media, formats, and markets now known or later discovered. This authorization shall continue indefinitely, unless otherwise revoked by Myo DIY in writing. In addition to communication with practitioners, Myo DIY may use photos for lawful promotional materials including but not limited to: websites, flyers, posters, brochures, videos, advertisements, social networking sites, and other print and digital communications, without payment or any other consideration. Client understands Myo DIY may crop, edit, draw upon, or otherwise edit any pictures or videos for educational, clarification, or identity protection purposes.
Please have a well-lit, quiet, private, location free from distractions and interruptions during Zoom calls. Also, please use a device that does not need to be held, as we may have to use both our hands.
Zoom calls while driving- even as a passenger- will not be accepted, due to zoom’s poor internet connection.
Parents/guardians are required to be present for the duration of the call with all children.
Quick review of key points: