Cancellation Request

First Name *

Last Name *

Phone *

Email *

Cancellation Reason *

I am unable to use the services as frequently as I would like

I am moving

I have purchased equipment and will be continuing at home

Military Deployment or Relocation

Medical Reasons

Other

Other Explanation

Cancellation Policy 90 Days *

I understand that if I am within the 90-day commitment period, I am responsible for the remaining balance

Cancellation Policy 30 Days *

I understand that I must submit my cancellation request at least 30-days prior to my next scheduled billing date

Cancellation Access *

I understand that I will have access to the Lab until the end of my current billing cycle and no remaining credits can be used after this date

Cancellation Membership Rate *

I understand that by canceling, I may lose my lower membership rate and will need to pay the current/increased membership rate at the time that I rejoin

Future Set Up Fee *

I understand that there will be a set-up fee to rejoin in the future