Envisia Plus Terms of Service

**Envisia Plus is not insurance.** It is an agreement to pre-pay for one year’s preventive care services outlined below at a discounted rate per service. You are obligated to pay for the entire one-year subscription with either monthly payments or in full to save a month’s payment.

Should you desire to terminate the agreement prior to utilizing any of the services, you will receive a full refund via whatever payment method you used unless you have utilized the discount for other dental services. The discount for other dental services shall not apply unless a total of three months premium has been received from your initial enrollment.

Should you wish to terminate mid-contract, the non-discounted standard office fees for whatever service you received shall be summed, and any excess payment above that will be refunded to you via whatever payment method you used. You will never pay more than your annual contract fee.

The discounted rate for other dental services is in effect for Kleer clients who recently signed up for this program within 60 days of this contract.

Members receive a **20% discount on all services** with the exception of Invisalign orthodontic products, which shall receive a **10% discount**. Your preventive services are covered as described on the plan options page.

We do offer extended-term financing, and if you want to take advantage of that, the discount will not apply due to the discount the providers of that service charge us to run those programs. There are same-as-cash options for these plans, which would help even things out against the loss of the discount upfront. If you split the fee as part paid and part financed, the discounts apply to the paid portion.

If you are currently a Kleer client, you still receive the same discounts, so you should not sign up for this until your contract with them expires. You get the same benefits as Envisia Plus. If you happen to get dental insurance while on Kleer, you have already “paid” us for the preventive services, so we may not bill your insurance for them until your contract expires. That would amount to double billing, which is illegal.

You agree to a one-year contract for pre-payment of the listed services depending on your choice of plans. The provided debit or credit card will be automatically charged monthly (starting month 4 for new enrollees who paid the 3-month downpayment). Kleer members will only need to make the month 1 payment to start.

Kleer members are reminded to call and cancel their membership with the company, or we can do it for them here because it automatically renews unless you tell them. Services provided with each plan are outlined on the attached page.

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**I agree to the terms described herein for payment of the membership in Envisia Plus**

**Please enroll me in (Initial box):** 

Basic [   ] 

Periodontal 3 [   ] 

Periodontal 4 [   ]

**Print name:** 

**Signature:** 

**Date:**

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