Membership Freeze Request All membership changes will be confirmed, please wait for confirmation via email to assure changes have been made.Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Primary Phone Number*Membership Type*PlatinumDual PlatinumHow many months have you been a member?*Between 3 and 12More than 12 monthsStatus Change Request*FreezeReason for Freeze?*Freeze Request - Member for more than 3 months* 1 month freeze 2 month freeze 3 month freeze Your membership will be frozen in 5 business days for the requested period of time. Please note your due date as dues may be processed prior to the freeze being processed. 1. During that period your account will not be charged on a monthly basis. 2. Since your account is frozen you will not be able to utilize any of your membership services/discount during this time. 3. Your will not lose any of your prepaid session; they will continue to roll over. 4. Your membership will automatically reinstate itself following your suspension. 5. If you are within the initial term of your agreement, the suspension will extend your agreement date out the equivalent number of days it is on hold. ( for example: If you are put on a 1 month suspension, your agreement will be extended out for 1 month) 6. If you have a declined payment, you will need to settle the overdue amount at time of reinstatement.Reason for termination*MedicalMovingReason for termination*MedicalMovingOtherDocumentation - Move*Max. file size: 100 MB.Please upload proof of move: USPS.com change of address form, utility bill, moving truck receipt, or any other documentation from a 3rd party source with your name and new address. Membership will be terminated immediately upon receipt of documentation. There will be no further dues processed or access to any banked sessions. Documentation - Move*Max. file size: 100 MB.Please upload proof of move: USPS.com change of address form, utility bill, moving truck receipt, or any other documentation from a 3rd party source with your name and new address. Membership will be terminated immediately upon receipt of documentation. There will be no further dues processed or access to any banked sessions. Documentation - Medical*Max. file size: 100 MB.Note from health care provider, treatment plan, or documentation that requests discontinuing services for medical reasons. Membership will be terminated immediately upon receipt of documentation. There will be no further dues processed or access to any banked sessions. Your membership is not currently eligible for termination. You are currently enrolled in a Platinum or Dual Platinum agreement. This is a 12 month membership agreement and your membership will be eligible for termination at the completion of the initial 12 months. If you would like to continue with the termination at the completion of the 12 months, please complete form as a "12 months or more" and we will clarify in our confirmation e-mail. If you have customer service concerns about your membership, please contact your spa at 952-995-9595.Reason for termination*CompetitionDifficulty Getting AppointmentDissatisfied with customer serviceFinancialLack of Use/Change of LifestyleMedicalMove: 30+ Miles From SpaPermanent Disability/DeathPrice IncreaseTherapist ChallengesReason for termination*CompetitionDifficulty Getting AppointmentDissatisfied with customer serviceFinancialLack of Use/Change of LifestyleMedicalMove: 30+ Miles From SpaPermanent Disability/DeathPrice IncreaseTherapist ChallengesYou are currently enrolled in our Platinum or Dual Platinum agreement which requires a 30 day notice to terminate. As long as you have completed the initial 12 month agreement and your dues are current, this form will be accepted as your 30 day notice to terminate. Please note your due date as there will be a final payment processed. Any banked sessions you may have will only be accessible up until the date of termination (30 calendar days from today). If you have any questions or need to book appointments, please call your spa 952-995-9595.You are currently enrolled in our Gold Membership agreement, which is a month to month agreement and requires a 60 day notice to terminate. As long as all dues are current, this notice will be accepted as your 60 day notice to terminate. Please note your due date as there will be 2 final payments processed. Any banked sessions you may have will only be accessible up until the date of termination (60 calendar days from today). If you have any questions or need to book appointments, please call your spa 952-995-9595.You are currently enrolled in our Gold Membership, which requires a 60 day notice for termination. Your request will be processed as of today, with your final date 60 days out from today. Please take note that there will be two additional month's of dues processed prior to termination. Any banked sessions you may have are only available up until the final date of your membership. Please call 952-995-9595 to book your sessions today!New Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country New PhoneNew Email Membership Freeze Request All membership changes will be confirmed, please wait for confirmation via email to assure changes have been made.Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Primary Phone Number*Membership Type*PlatinumDual PlatinumHow many months have you been a member?*Between 3 and 12More than 12 monthsStatus Change Request*FreezeReason for Freeze?*Freeze Request - Member for more than 3 months* 1 month freeze 2 month freeze 3 month freeze Your membership will be frozen in 5 business days for the requested period of time. Please note your due date as dues may be processed prior to the freeze being processed. 1. During that period your account will not be charged on a monthly basis. 2. Since your account is frozen you will not be able to utilize any of your membership services/discount during this time. 3. Your will not lose any of your prepaid session; they will continue to roll over. 4. Your membership will automatically reinstate itself following your suspension. 5. If you are within the initial term of your agreement, the suspension will extend your agreement date out the equivalent number of days it is on hold. ( for example: If you are put on a 1 month suspension, your agreement will be extended out for 1 month) 6. If you have a declined payment, you will need to settle the overdue amount at time of reinstatement.Reason for termination*MedicalMovingReason for termination*MedicalMovingOtherDocumentation - Move*Max. file size: 100 MB.Please upload proof of move: USPS.com change of address form, utility bill, moving truck receipt, or any other documentation from a 3rd party source with your name and new address. Membership will be terminated immediately upon receipt of documentation. There will be no further dues processed or access to any banked sessions. Documentation - Move*Max. file size: 100 MB.Please upload proof of move: USPS.com change of address form, utility bill, moving truck receipt, or any other documentation from a 3rd party source with your name and new address. Membership will be terminated immediately upon receipt of documentation. There will be no further dues processed or access to any banked sessions. Documentation - Medical*Max. file size: 100 MB.Note from health care provider, treatment plan, or documentation that requests discontinuing services for medical reasons. Membership will be terminated immediately upon receipt of documentation. There will be no further dues processed or access to any banked sessions. Your membership is not currently eligible for termination. You are currently enrolled in a Platinum or Dual Platinum agreement. This is a 12 month membership agreement and your membership will be eligible for termination at the completion of the initial 12 months. If you would like to continue with the termination at the completion of the 12 months, please complete form as a "12 months or more" and we will clarify in our confirmation e-mail. If you have customer service concerns about your membership, please contact your spa at 952-995-9595.Reason for termination*CompetitionDifficulty Getting AppointmentDissatisfied with customer serviceFinancialLack of Use/Change of LifestyleMedicalMove: 30+ Miles From SpaPermanent Disability/DeathPrice IncreaseTherapist ChallengesReason for termination*CompetitionDifficulty Getting AppointmentDissatisfied with customer serviceFinancialLack of Use/Change of LifestyleMedicalMove: 30+ Miles From SpaPermanent Disability/DeathPrice IncreaseTherapist ChallengesYou are currently enrolled in our Platinum or Dual Platinum agreement which requires a 30 day notice to terminate. As long as you have completed the initial 12 month agreement and your dues are current, this form will be accepted as your 30 day notice to terminate. Please note your due date as there will be a final payment processed. Any banked sessions you may have will only be accessible up until the date of termination (30 calendar days from today). If you have any questions or need to book appointments, please call your spa 952-995-9595.You are currently enrolled in our Gold Membership agreement, which is a month to month agreement and requires a 60 day notice to terminate. As long as all dues are current, this notice will be accepted as your 60 day notice to terminate. Please note your due date as there will be 2 final payments processed. Any banked sessions you may have will only be accessible up until the date of termination (60 calendar days from today). If you have any questions or need to book appointments, please call your spa 952-995-9595.You are currently enrolled in our Gold Membership, which requires a 60 day notice for termination. Your request will be processed as of today, with your final date 60 days out from today. Please take note that there will be two additional month's of dues processed prior to termination. Any banked sessions you may have are only available up until the final date of your membership. Please call 952-995-9595 to book your sessions today!New Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country New PhoneNew Email
