Individual Plan Register & Pay (1 Month)

1 Month Individual Plan

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This certifies that you agree to receive services for a 12-Month period that begins after submission of this form and the following payment. Understand that is not a diagnosis and based on self reporting, we encourage to always contact a physician with medical advice or issues. By submitting this form, you acknowledge that the services offered do not represent fitness training, psychological counseling or any kind of therapy or acting as a Nutritionist of Dietician. Agree to hold ASA Wellness free from all liability for any actions or results for adverse situations created as a direct or indirect result of advice given by the HRA. You acknowledge that you have carefully read these Terms and Conditions and fully understand that it is a release of liability. Expressly agree to release any employee or representative from any and all claims or causes of action and agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against them or American Screening Association, Inc.

I have read and agree to the above Terms & Conditions

All information is kept confidential and private, review our Privacy Policy

This plan includes the following benefits for ONE MONTH ONLY: One Health Risk Assessments, including editing and updating for that single month. One Downloadable and Printable Report to Share with your Physician. Free Access to Health Shelf Resources within your HRA Portal. Complimentary ASA Wellness Tools to apply to your everyday life.

$18.00

Individual Plan Register & Pay (1 Month)

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