Membership Change Request

Here you can either cancel, upgrade, or downgrade your membership.

Upgrade or Downgrade Your Membership

Need to Make Changes to Your Membership? 

Downgrading:

1. Submit this form. 

2. Your membership will be changed within 5 business days of this request. (You must make this request at a minimum of 5 business days before your renewal date).

3. Your payments will continue as normal. 

Upgrading:

1. Submit this form. 

2. Your membership will be changed within 5 business days of this request, and you will be charged for the new membership level on that date. (You must make this request at a minimum of 5 business days before your renewal date).

3. Your payments will continue as normal. 

You cannot upgrade or downgrade a membership more than 1 time every 3 months without a $25 change fee. 

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Name*
Location
Change My Membership to:
MM slash DD slash YYYY

Cancel Your Membership

We Are Sad to See You Go!

We have loved having you be a member at Axcess Accident Center. If there is anything we can do to improve your experience, please let us know and we will make it right! 

To Cancel Your Membership: 

1- Complete the Request Form

2- We Will Contact You to Charge the $75 Cancellation Fee, Where Applicable 

3- Get a Receipt & Email Confirmation of Membership Canceled

 

Important Information Related to Canceling Your Membership or Transferring to a New Location:

Axcess Membership is based on a minimum of 6 months. Please note that the promotional value each month is to be used while you are a member.

If after your membership the promotional value is not used your membership payment will apply as a normal payment at non-promotional pricing. ($45 Chiropractic/Acupuncture or $55 for an hour massage) This value can be used for up to 1 year after purchase. To transfer funds to another person there is a $75 transfer fee.

If canceling your membership before 6 months there is a $75 cancellation fee and by submitting the form on this page you agree to us processing this charge on the card we have on file. If you have any questions please reach out to us at patient@axcessac.com.

"*" indicates required fields

Name*
Location
MM slash DD slash YYYY

Hours

M/W/F: 9am-6:30pm
T/Th: 2-6pm
S/S: Closed