Need to cancel your membership?

No problem! Just fill out the form below, and your cancellation will be processed. Your membership benefits will continue through the end of your current month. You’ll receive confirmation that your membership has been canceled via the email address provided below, so please make sure it is the best email address for you!

Please note: all cancellation requests require at least 15 days notice. You will be charged for your final month if your next payment is due during that timeframe. To avoid this charge, please submit your cancellation request before the 15th of the month!

If you have any questions about your membership or the cancellation process, please email me at kate@fireweedacupuncture.com.

Name

First Name

Last Name

Email on membership (if different)

Phone

(###)

###

####

Which membership are you signed up for?

Acupuncture-Only (60 minute)

Acupuncture-Only (90 minute)

Acupuncture + Bodywork (60 minute)

Acupuncture + Bodywork (90 minute)

Acupuncture + Holistic Facial Rejuvenation (90 minute)

What is the reason for canceling?

No answer required, but this helps me make sure the memberships continue to be a benefit for people in the future!

Any additional information you'd like to share?

Confirmation

Please review this information carefully prior to submitting!

By checking this box, I am confirming that I wish to cancel my membership. I understand that my membership request may take up to 15 days to process, and if my next membership charge was due within these 15 days, I will be charged for an additional month prior to cancellation. I acknowledge that my membership will end at the end of month I have paid for and that my discounts and additional membership benefits will expire at the end of the month. Finally, I understand that any remaining visits must be used within 30 days of the end of my final month, after which the visits will expire.

Need to cancel your membership?

Location

Hours

Contact