Consent to Electronic Agreements and Communication

I, the undersigned, hereby agree and consent to enter into and sign agreements with Lock and Key Wellness (LKW) electronically, and to receive notices, notifications and communications from LKW electronically, as set forth more fully herein.

I acknowledge and agree that: Electronic Agreements and Signatures

1. LKW and I can enter into and sign agreements electronically, including without limitation, subscription agreements, limited liability LKW agreements, and amendments to agreements (collectively “Agreements”).
2. My use of a key pad, mouse or other device to select an item, button, icon or similar act /action, or to otherwise provide instructions to LKW electronically, or in accessing or making any transaction regarding any Agreement, acknowledgement, consent, terms, disclosures or conditions constitutes my signature (my “E-Signature”), acceptance and agreement the same as if actually signed by me in writing.
3. I agree that no certification authority or other third party verification is necessary to validate my E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of my E-Signature or any resulting contract between me and LKW.
4. I represent that I am authorized to enter into this Consent and future Agreements to all persons who own or are authorized to access any of my accounts, and that such persons will be bound by the terms of this Consent.
5. The parties’ electronic signatures shall be valid and enforceable in accordance with the Electronic Signatures in Global and National Commerce Act (“E-SIGN”), 15 U.S.C. 7001, et seq.
6. All Agreements shall constitute original documents admissible in a court of law when printed from electronic files and records established and maintained by either party in the normal course of business.

Electronic Delivery of Communications

I agree to receive electronically all communications, documents, notices and disclosures (collectively, “Communications”) that LKW provides in connection with my account and transactions (collectively “Account”) with LKW. Communications include:

• Transaction receipts and confirmations;
• Invoices and statements for services rendered;
• Account statements and history;
• Any other Account or transaction information.

How I Can Withdraw Consent

I understand I may withdraw my consent of E-Signature and/or to receive electronic Communications by emailing LKW at:

info@lockandkeywellness.com

If I fail to provide or if I withdraw my consent to receive Communications electronically, LKW reserves the right to either deny my application for an Account, restrict or deactivate my Account, or close my Account.

Updating my Contact Information

It is my responsibility to keep my primary email address up to date so that LKW can communicate with me electronically. I understand and agree that if LKW sends me an electronic communication but I do not receive it because my primary email address on file is incorrect, out of date, blocked by my service provider, or I am otherwise unable to receive electronic Communications, LKW will still be deemed to have provided the Communication to me.

I understand that if I use a spam filter that blocks or re-routes emails from senders not listed in my email address book, I must add LKW to my email address book so that I will be able to receive the Communications LKW sends to me.

I can update my primary email address or street address at any time by contacting LKW. If my email address becomes invalid such that electronic Communications sent to me by LKW are returned, LKW may deem my Account to be inactive, and I will not be able to transact any activity using my Account until LKW receives a valid, working primary email address from me.

Hardware and Software Requirements

To receive electronic communications, I understand I must have a computer, tablet, smartphone or similar device that can access the Internet and my email account and address where LKW may communication with me via email. My click-acceptance of this Consent electronically demonstrates that my ability to access Communications and other information electronically.

Electronic Acknowledgement/Signature Page will be sent through the portal with your Patient Questionnaires.

If you have any questions, please contact us at 1-656-227-9547 or email us at info@lockandkeywellness.com