Templates · Free template · Policies
Treatment Package and Membership Agreement Template
A printable agreement for prepaid treatment packages and memberships that spells out what is included, how it is paid for, when it expires, and what happens if the client cancels.
Most disputes are about expiry and refunds
Packages are popular and so are the disagreements they cause: unused sessions, expiry dates, and refunds. Write down each of them, in plain language, before payment.
Consumer protection rules on prepaid services and gift cards vary by province, particularly on expiry. Check yours before setting terms, and have your lawyer review the final wording.
Treatment Package and Membership Agreement
Client
Package
Terms
Acknowledgement
Signatures
Template from zdrovia.ca/templates/treatment-package-agreement-template/ · Review with your medical director, regulatory college guidance, and insurer before use.
Send this form before the appointment instead of printing it
Zdrovia's form builder turns this template into a digital form your clients sign on their own phone. The signed copy files into their chart with the exact version they saw, and photo consent stays separate from treatment consent. It's free for solo practitioners, with data stored in Canada.
See how Zdrovia is set up for med spas.
Frequently asked questions
Can packages expire?
Rules on expiry vary by province. Check consumer protection law before setting one.
Should I include a refund policy?
Yes. State it plainly, including how used sessions are valued.
Related
This template is a starting point for discussion with your team and advisors, not legal or medical advice. Requirements vary by province and profession. Have your medical director, your regulatory college's guidance, and your malpractice insurer confirm the wording before you use it with patients.