Financial policy.
Membership Agreement
1. Patient-Clinician Relationship
By your signature, you acknowledge that you are voluntarily becoming a patient of Lifestyles by Noor LLC and its affiliated clinician(s). As a patient, the services described in Section 2 will be made available to you pursuant to the terms of this Membership Agreement.
2. Lifestyles by Noor LLC Services
As a patient, you are eligible to receive primary care, preventive care, and urgent care services as outlined in the Detailed Service List. Services may evolve over time and will be reflected in the updated service list. All medical services are provided by appropriately licensed practitioners.
Lifestyles by Noor LLC is not health insurance and does not bill insurance for covered services under this Agreement. Patients are encouraged to maintain separate health insurance coverage for services outside of this scope (e.g., labs, imaging, hospital care).
The Practice reserves the right to decline or discontinue services under certain circumstances, including non-payment or inability to meet clinical needs.
3. Fees and Payment
Membership and Service Fees
Fees for memberships, packages, and individual services, whether provided to members or non-members, are listed on the Detailed Service List. By signing this Agreement, you acknowledge that you have received and reviewed the Detailed Service List, including the applicable fees.
The Practice may update fees on the Detailed Service List with 30 days’ written notice.
Payment Terms
Membership fees are due in full at enrollment unless enrolled in an approved monthly auto-payment plan. Annual memberships may receive a 10% discount if paid in full.
All payments must be kept current. Declined transactions may incur a $50 administrative fee. Services may be suspended for past-due accounts. The Practice does not accept checks.
Refund Policy
All membership fees are non-refundable.
New Patient Consultation Cancellation and No-Show Policy
Due to high demand and the dedicated time reserved for each new patient consultation, appointments canceled or missed with less than 24 hours’ notice will incur an $800 fee, reflecting the full cost of the reserved consultation time with Dr. Noor.
By scheduling a new patient consultation, you acknowledge and agree to this policy.
Additional Services
Certain services are not included in membership fees. These services, and all services provided to non-members, are charged at the rates listed on the Detailed Service List.
4. Your Medical Information
Your privacy is important to us. Lifestyles by Noor LLC complies with HIPAA regulations and maintains safeguards to protect your health information. By entering this Agreement, you consent to appropriate sharing of medical information as necessary for your care.
5. Digital Communications
You consent to communication via phone, email, and electronic messaging. While reasonable safeguards are in place, electronic communication may not always be secure.
Electronic communication should not be used for urgent or emergency matters. In emergencies, call 911 or go to the nearest emergency department.
6. Term and Termination
This Agreement is valid for one year and will automatically renew unless canceled with at least 60 days’ written notice.
The Practice may terminate this Agreement for reasons including non-payment, breach of agreement, or inappropriate behavior.
Membership fees are non-refundable.
7. Independent Medical Judgment
All medical decisions are made at the sole discretion of the clinician, based on professional judgment and patient needs.
8. Terms of Usage
The Practice may establish additional policies or terms, which will be communicated in writing and will supplement this Agreement.
9. Change of Law
If legal or regulatory changes impact this Agreement, both parties agree to renegotiate terms in good faith. If no agreement is reached, either party may terminate the Agreement.
10. Severability and Assignment
If any provision is found invalid, the remaining provisions will remain in effect. This Agreement may not be assigned to another individual.
11. Notice
Official communications must be made in writing via approved methods (mail, courier, etc.).
12. Legal Significance
This is a legally binding document. You acknowledge that you have had the opportunity to seek legal counsel prior to signing.
13. Governing Law; Arbitration
This Agreement is governed by the laws of the State of New Hampshire. Any disputes will be resolved through binding arbitration.
14. Waiver
Failure to enforce any part of this Agreement does not waive the right to enforce it in the future.
15. Miscellaneous
Section headings are for convenience only and do not affect interpretation.
16. Entire Agreement
This Agreement, together with the Detailed Service List, represents the full agreement between the parties and supersedes all prior agreements.
Contact Information
If you have a complaint, please contact Lifestyles by Noor LLC clinic directly or Lifestyles by Noor LLC in any of the following ways:
Email: info@lifestylesbynoor.com
Mail: 1 Hampton Road, Suite 210, Exeter, NH 03833
Phone: (603) 686-5515
Fax: (603) 583-5610