Corey Aesthetics Membership Agreement

1.Membership Term and Fees

Member agrees to a twelve (12) month membership commitment beginning on the Effective Date (the “Initial Term”).

Member shall pay a membership fee of Ninety-Nine Dollars ($99.00) per month. The Membership Fee is due on the same calendar day each month as the Effective Date (or the last day of the month if no corresponding day exists).

Member authorizes Practice to automatically charge the credit or debit card on file each month. Member is responsible for keeping payment information current. Failed payments may result in suspension of Membership privileges until cured.

Membership Fees are non-refundable except as provided in Section 12 (Right to Cancel). All value is provided solely through Service Credits.

2.Service Credits (“Banking”)

Each paid Membership Fee generates a Service Credit equal to One Hundred Percent (100%) of the amount paid — $99.00 credit for each $99.00 payment. Credits are applied to Member’s account balance upon successful payment.

Service Credits may be applied toward eligible Corey Aesthetics services: neuromodulators (Botox, Dysport, Daxxify, Xeomin), hyaluronic acid fillers (Juvéderm, Restylane, RHA Collection), semi-permanent fillers (Sculptra, Radiesse), microneedling (including Ariessence Pure PDGF+), IPL, laser hair removal, skin peels, microdermabrasion, and facials (Signature and DiamondGlow). Surgical procedures and medical services requiring anesthesia are generally excluded unless expressly approved in writing.

Credits are applied at the time of service, to the Member price then in effect. Member must have sufficient credit balance to cover the applicable charges (or pay any remaining balance by another accepted method). Credits have no cash value and cannot be redeemed for cash, transferred, or sold.

Unused Service Credits remain available only while the Membership is active. Upon lapse or termination for any reason, all unused Service Credits expire immediately and are forfeited.

While Membership is active, Member pricing published by Practice applies to eligible services: one dollar ($1.00) off each unit of neuromodulator (Botox, Dysport, Daxxify, and Xeomin), and ten percent (10%) off other eligible treatments including hyaluronic acid fillers, Sculptra, Radiesse, DiamondGlow, microneedling, peels, microdermabrasion, IPL, and laser hair removal. Service Credits apply to the Member price. Practice may modify Eligible Services, Member pricing, and retail pricing with reasonable notice.

3.Commitment; Early Termination

By signing, Member commits to the full twelve (12) month Initial Term and the corresponding Membership Fees, subject to the right of cancellation in Section 12.

If Member wishes to terminate prior to the end of the Initial Term, Member shall provide written notice and remain responsible for all remaining unpaid Membership Fees for the balance of the Initial Term, payable as a single lump-sum (the “Early Termination Amount”). Practice may, at its sole discretion, offer a reduced settlement. Failure to pay may result in referral to collections and/or credit reporting as permitted by law.

Practice may temporarily suspend Membership privileges for non-payment without terminating the Agreement. Suspension does not relieve Member of the obligation to pay Membership Fees.

3.4.Temporary Voluntary Suspension for Dual Residents (“Snowbird”)

Members who maintain dual residency (seasonal residents or “snowbirds”) may request a temporary voluntary suspension while residing at their secondary residence.

• Provide reasonable evidence of dual residency (utility bill, lease, property tax statement, or other documentation acceptable to Practice).
• Submit a written request at least fourteen (14) days prior to the desired start date.
• During an approved suspension, elect either (i) to continue paying and accruing credits, or (ii) to suspend both payments and credit accrual. No credits accrue during a payment-suspension election.
• The Initial Term remains in effect. Months with suspended payments do not count toward the twelve paid months; the term is extended so Member still completes twelve (12) paid months.
• Canceling during or at the end of a voluntary suspension (or failing to resume) requires a true-up of remaining months needed to reach twelve paid months, as a lump sum.
• Practice may limit cumulative suspension length and deny requests that appear abusive or inconsistent with dual-residency purpose.

3.5.Medical Suspension

Member may request a temporary medical suspension for a qualifying medical condition that reasonably prevents use of Corey Aesthetics services — including significant injury, surgery, pregnancy, or other circumstances documented by a licensed healthcare provider.

• Submit a written request with medical documentation reasonably satisfactory to Practice.
• Upon approval, both payments and credit accrual suspend for the approved period.
• Medical-suspension months do not count toward the twelve-month Initial Term; the term extends so Member still completes twelve paid months after the suspension ends.
• Suspensions are intended to be temporary. Practice may require updates. Extended or indefinite suspensions may be treated as a termination under Early Termination, or continued on mutually agreed written terms.
• Canceling during an approved medical suspension triggers the Early Termination Amount unless Practice, in its sole discretion, waives or reduces it due to the nature of the medical circumstances.

4.Renewal

Upon completion of the Initial Term, this Agreement automatically converts to a month-to-month membership at the then-current Membership Fee (which Practice may adjust with at least thirty (30) days’ prior written notice), unless either party provides written notice of non-renewal at least thirty (30) days prior to the end of the Initial Term.

During the month-to-month period, either party may terminate by providing at least thirty (30) days’ written notice. Member is responsible for Membership Fees through the effective termination date. The same banking and credit rules apply.

5.Membership Privileges and Limitations

Membership is personal to the named Member and may not be transferred, assigned, or shared.

Membership and the use of credits do not guarantee any particular aesthetic or medical outcome. All treatments remain subject to clinical appropriateness, informed consent, and the professional judgment of the treating provider.

Execution of this Agreement does not constitute consent to any specific treatment. Separate informed consent documents are required prior to each treatment.

Practice will make reasonable efforts to accommodate appointments; Membership does not guarantee preferred scheduling or immediate availability of any particular provider or service.

6.Cancellation of Automatic Payments

Canceling or changing the payment method on file does not constitute cancellation of this Membership Agreement. Member remains fully obligated for all Membership Fees for the full Initial Term (or applicable notice period during any month-to-month period) unless properly terminated under Sections 3, 4, or 12.

7.Member Representations

Member represents and warrants that: (a) Member is at least eighteen (18) years of age; (b) all information provided to Practice is accurate and complete; and (c) Member has read, understands, and agrees to be bound by this Agreement.

8.Limitation of Liability; Disclaimer

To the maximum extent permitted by law, Practice’s total liability arising out of or related to this Agreement shall not exceed the total Membership Fees paid by Member during the twelve (12) months preceding the claim. Practice shall not be liable for any indirect, incidental, special, consequential, or punitive damages. The foregoing does not limit liability for gross negligence, willful misconduct, or any liability that cannot be limited under applicable law (including medical malpractice claims arising from actual treatment, which are governed by separate professional liability principles).

9.Governing Law and Dispute Resolution

This Agreement shall be governed by the laws of the State of Indiana, without regard to conflict of law principles. Any dispute arising under this Agreement shall first be attempted to be resolved through good-faith negotiation. If unresolved, the parties agree to binding arbitration in Allen County, Indiana, under the rules of the American Arbitration Association, except that either party may seek injunctive or other equitable relief in a court of competent jurisdiction.

10.Miscellaneous

This Agreement constitutes the entire agreement between the parties concerning the subject matter hereof and supersedes all prior discussions and agreements.

Practice may update the terms of this Membership program upon thirty (30) days’ written notice. Continued payment of the Membership Fee after the effective date of changes constitutes acceptance of the revised terms. Material adverse changes may give Member the right to terminate without Early Termination Amount if exercised within the notice period.

If any provision is held unenforceable, the remaining provisions shall continue in full force.

Written notice under this Agreement must be hand delivered or sent by certified mail. Email is not sufficient.

Electronic signatures (including DocuSign, Adobe Sign, or similar platforms) are valid and binding.

11.Medical Spa Compliance (Indiana IC 25-22.5-12.5)

Member acknowledges that Corey Aesthetics operates as a medical spa within the meaning of Indiana Code 25-22.5-12.5 (as enacted by SEA 282 / Public Law 136). The following provisions reflect requirements applicable under that statute and related regulations:

Registration. Beginning January 1, 2027, the Practice is required to be registered with the Indiana Medical Licensing Board in order to operate as a medical spa. The Practice will maintain such registration as required by law. Member may verify registration status through the public database maintained by the Board once available.

Responsible Practitioner. The Practice designates Samuel L. Corey II, MD (or another qualified practitioner with prescriptive authority as required by the Board) as the responsible practitioner. The responsible practitioner has education and training in the health care services, treatments, and medications provided at the facility and shall be physically present at the location for a sufficient amount of time to ensure compliance with applicable requirements. The responsible practitioner oversees that individuals performing services are appropriately licensed and acting within their scope of practice.

Location of Services. Health care services and cosmetic or lifestyle treatments are provided at the registered medical spa location (2510 E Dupont Rd, Suite 236, Fort Wayne, IN 46825), except as otherwise permitted by law (including limited educational or training exceptions). Services are not provided at off-site locations such as private residences or public places except where expressly authorized.

Serious Adverse Event Reporting. The Practice is required to report serious adverse events associated with treatments or prescription medications to the Indiana Medical Licensing Board within the timeframe prescribed by law (currently within fifteen (15) days). Member acknowledges that the Practice will comply with these reporting obligations.

Advertising and Other Compliance. The Practice’s advertising and promotional materials will comply with applicable health care advertising laws and will not contain deceptive or misleading information. All treatments remain subject to clinical assessment, informed consent, and professional judgment.

Most operational requirements under IC 25-22.5-12.5 take effect July 1, 2026, with mandatory registration effective January 1, 2027. The Practice reserves the right to update membership materials and procedures as the Medical Licensing Board issues further rules or guidance implementing the statute.

12.Right to Cancel (Indiana Health Spa Services Act — IC 24-5-7-5)

YOU, THE BUYER, MAY CANCEL THIS CONTRACT AT ANY TIME BEFORE MIDNIGHT OF THE THIRD FULL BUSINESS DAY AFTER THE DATE OF THE TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.

In accordance with Indiana Code 24-5-7-5, Member may cancel this Membership Agreement before midnight of the third full business day after Member signs the contract. Cancellation must be made by written notice, in any form, hand delivered or sent by certified mail to the Practice at the address specified below. Any membership cards previously delivered must accompany the notice.

All money paid under this contract shall be refunded within thirty (30) days of the Practice’s receipt of the notice of cancellation.

To cancel, hand deliver or send by certified mail written notice to: Aesthetic Medicine Consulting, PC d/b/a Summit Plastic Surgery / Corey Aesthetics, 2510 E Dupont Rd, Suite 236, Fort Wayne, IN 46825.

This right of cancellation is in addition to any other rights Member may have under this Agreement or applicable law. Waiver of the provisions of the Health Spa Services Act is void.