Annual Program Agreement
Please fill in your details, read the terms carefully, and sign digitally at the bottom.
Personal Details
Program Terms
1. Introduction and Declaration of Consent
Welcome to the annual support program of Daniel Elyakim Clinic for Chinese Medicine. This document outlines the terms of participation in the program in a clear and transparent manner. By signing this document, you signify your full agreement to all the terms set forth below.
2. Annual Treatment Scope
The support program includes weekly treatment sessions throughout the year, with a total of up to 48 treatments per year. Treatments are divided into monthly packages, with each month including a fixed number of treatments as specified in the selected package.
Treatments not used in a given month may be carried over to the following month, subject to prior coordination and the practitioner’s approval. There is no overuse of treatments beyond the annual quota.
3. Payment Method — Calendar-Based Standing Order
The monthly payment is made via a bank standing order. The charge is processed on the monthly anniversary of the program start date — that is, if you began the program on the 15th of the month, the monthly charge will be processed on the 15th of each subsequent month.
The charge is proportional to the period that has passed and is based on the calendar, not fixed on the 1st of each month. There is no advance charge for the following month — each charge covers the period that has actually elapsed.
4. Client Absence
If you need to cancel a treatment, please notify us at least 24 hours in advance. A treatment cancelled with prior notice will be rescheduled to an alternative date at no additional charge.
A treatment missed without prior notice will be counted as a used treatment. The subscription may be frozen for up to 30 days per year (consecutive or divided) at no additional charge.
5. Practitioner Absence (Separate Clause)
In the event of the practitioner’s absence — vacation, illness, professional training, or any other reason — no charge will be made for treatments that did not take place.
The practitioner will notify in advance of planned absences. In the case of a sudden absence, the practitioner will coordinate an alternative date or credit the client for the missed treatment.
The practitioner’s absence does not affect the continuity of the annual treatments and does not shorten the subscription’s validity. The client will not suffer financially from the practitioner’s absence in any case.
6. Subscription Validity and Renewal
The annual subscription renews automatically each year, unless you notify us of cancellation at least 30 days before the end of the subscription period.
You may upgrade or change the package type at any time, in coordination with the practitioner and subject to current terms.
7. Subscription Cancellation
The subscription may be cancelled at any time by written notice (email or message) at least 30 days before the next billing date.
Cancellation during a billing period — the proportional balance from the cancellation date to the end of the paid period will be credited.
8. Confidentiality and Privacy
All medical and personal information provided during treatments will be kept strictly confidential, in accordance with the Privacy Protection Law 5741-1981 and the Patient’s Rights Law 5756-1996.
The information will be used for treatment purposes only and will not be transferred to any third party without your explicit written consent.
9. Limitation of Liability
The treatments offered under the support program are complementary Chinese medicine treatments. They are not a substitute for conventional medical advice or treatment.
The practitioner is not responsible for outcomes beyond their control, including medical conditions outside their scope of practice. It is recommended to consult a physician regarding any complex medical condition.
10. Consent and Signature
I, the undersigned, hereby declare that I have read all the terms of this agreement, fully understood them, and I agree to all that is stated herein.
The digital signature below constitutes full and binding consent, in accordance with the Electronic Signature Law 5761-2001.
חתמו כאן עם האצבע או העכבר
Annual Program Agreement
Daniel Elyakim — Chinese Medicine
decmc.co.il | info@decmc.co.il
Client Details
Name:
ID:
Phone:
Email:
Date: 11/4/2026
Program Type:
1. Introduction and Declaration of Consent
Welcome to the annual support program of Daniel Elyakim Clinic for Chinese Medicine. This document outlines the terms of participation in the program in a clear and transparent manner. By signing this document, you signify your full agreement to all the terms set forth below.
2. Annual Treatment Scope
The support program includes weekly treatment sessions throughout the year, with a total of up to 48 treatments per year. Treatments are divided into monthly packages, with each month including a fixed number of treatments as specified in the selected package.
Treatments not used in a given month may be carried over to the following month, subject to prior coordination and the practitioner’s approval. There is no overuse of treatments beyond the annual quota.
3. Payment Method — Calendar-Based Standing Order
The monthly payment is made via a bank standing order. The charge is processed on the monthly anniversary of the program start date — that is, if you began the program on the 15th of the month, the monthly charge will be processed on the 15th of each subsequent month.
The charge is proportional to the period that has passed and is based on the calendar, not fixed on the 1st of each month. There is no advance charge for the following month — each charge covers the period that has actually elapsed.
4. Client Absence
If you need to cancel a treatment, please notify us at least 24 hours in advance. A treatment cancelled with prior notice will be rescheduled to an alternative date at no additional charge.
A treatment missed without prior notice will be counted as a used treatment. The subscription may be frozen for up to 30 days per year (consecutive or divided) at no additional charge.
5. Practitioner Absence (Separate Clause)
In the event of the practitioner’s absence — vacation, illness, professional training, or any other reason — no charge will be made for treatments that did not take place.
The practitioner will notify in advance of planned absences. In the case of a sudden absence, the practitioner will coordinate an alternative date or credit the client for the missed treatment.
The practitioner’s absence does not affect the continuity of the annual treatments and does not shorten the subscription’s validity. The client will not suffer financially from the practitioner’s absence in any case.
6. Subscription Validity and Renewal
The annual subscription renews automatically each year, unless you notify us of cancellation at least 30 days before the end of the subscription period.
You may upgrade or change the package type at any time, in coordination with the practitioner and subject to current terms.
7. Subscription Cancellation
The subscription may be cancelled at any time by written notice (email or message) at least 30 days before the next billing date.
Cancellation during a billing period — the proportional balance from the cancellation date to the end of the paid period will be credited.
8. Confidentiality and Privacy
All medical and personal information provided during treatments will be kept strictly confidential, in accordance with the Privacy Protection Law 5741-1981 and the Patient’s Rights Law 5756-1996.
The information will be used for treatment purposes only and will not be transferred to any third party without your explicit written consent.
9. Limitation of Liability
The treatments offered under the support program are complementary Chinese medicine treatments. They are not a substitute for conventional medical advice or treatment.
The practitioner is not responsible for outcomes beyond their control, including medical conditions outside their scope of practice. It is recommended to consult a physician regarding any complex medical condition.
10. Consent and Signature
I, the undersigned, hereby declare that I have read all the terms of this agreement, fully understood them, and I agree to all that is stated herein.
The digital signature below constitutes full and binding consent, in accordance with the Electronic Signature Law 5761-2001.
Digital Signature:
Signed digitally in accordance with the Electronic Signature Law 5761-2001