BUSINESS INFORMATION
PHYSICIAN / LICENSE INFORMATION
PAYMENT AUTHORIZATION (STANDING)
I, the undersigned, as an authorized representative of the above-referenced clinic/practice (“Client”), hereby authorize Bio Longevity Group LLC (CureHealth Peptides) to charge and/or debit the approved payment method(s) on file for:
• Any and all orders submitted by the Client
• Peptides, products, and related services
• Shipping, handling, and applicable fees
CREDIT CARD AUTHORIZATION
The Client authorizes CureHealth Peptides to charge the credit card stored securely on file for all submitted
orders.
The Client agrees:
• Each order submission constitutes explicit authorization for charge
• Only authorized personnel will have access to place orders
• The Client is responsible for all charges incurred
All credit card transactions will be charged a 3.5% fee.
ACH AUTHORIZATION
By selecting ACH, the Client authorizes CureHealth Peptides to initiate debit entries from the account below:
ACH Terms:
• Each order submitted = authorization for debit
• Client must maintain sufficient funds
• Returned payments may incur fees
• Orders may be held until funds are confirmed
WIRE TRANSFER AUTHORIZATION
By selecting wire transfer, the Client agrees to remit payment per CureHealth Peptides’ instructions.
Wire Terms:
• Payment must be initiated promptly upon invoicing
• Order/Invoice ID must be included in reference
• Client is responsible for all wire fees
• Orders may be delayed until funds are received
SCOPE OF AUTHORIZATION
This is a standing (ongoing) authorization that includes:
• One-time purchases
• Recurring or restock orders
• Automated or standing inventory programs
Each order placed through the CureHealth Peptides platform constitutes a binding approval of associated charges.
RESPONSIBILITY & ACCOUNT CONTROL
The Client agrees:
• To restrict ordering access to authorized personnel only
• To monitor account activity and charges
• That CureHealth Peptides may rely on submitted orders as valid and authorized
DISPUTES & CHARGEBACK AGREEMENT
The Client agrees:
• To review all transactions promptly
• To contact CureHealth Peptides directly to resolve any billing issues
The Client further agrees:
• Not to initiate chargebacks for valid, fulfilled orders
• That all submitted orders represent authorized business transactions
NON-CARD PAYMENT OBLIGATION
For ACH and wire transactions:
• Orders constitute a binding financial obligation
• CureHealth Peptides may delay or suspend fulfillment for:
• Payment failure
• Delayed payment
• Risk concerns
CureHealth Peptides reserves the right to:
• Require prepayment
• Change accepted payment methods at any time
DEFAULT & COLLECTION
In the event of non-payment, the Client agrees:
• CureHealth Peptides may pursue collection efforts
• The Client is responsible for:
- Collection costs
- Reasonable legal fees (where permitted)
COMPLIANCE ACKNOWLEDGMENT
The Client confirms:
• All orders are placed under licensed medical authority
• Products are for clinical or provider-directed use only
• The Client is responsible for compliance with all applicable laws and regulations
TERM & REVOCATION
This authorization remains in effect until:
• Written cancellation is received, and
• A minimum of 5 business days is provided for processing
Revocation does not apply to:
• Orders already submitted
• Charges already initiated
LIMITATION OF ROLE
CureHealth Peptides acts solely as a supplier fulfilling provider-directed orders and is not engaged in direct-to-consumer sales.
ELECTRONIC SIGNATURE CONSENT
The Client agrees:
• This agreement may be executed electronically
• Electronic signatures (typed, drawn, or verified) are legally binding
• Records will be retained for verification and compliance
AUTHORIZED SIGNATURE
*All statements, payments, and invoicing will be issued under “Bio Longevity Group LLC”
