Summit Membership Cancellation

Please complete and submit this form as notification to cancel your Summit Medical Fitness Center. Please review all the information below regarding our cancellation process before submitting form. You will receive a confirmation email that the form has been submitted. Once reviewed by Member Services you will receive a cancellation confirmation. Please keep all confirmation emails for your record. Thank you.

Notification to Cancel Membership Procedure and Policy:
In accordance with The Summit Medical Fitness Center Policies and Procedures, I am hereby giving my written notice of cancellation.  I understand that membership and billing are not based on usage. Members are responsible for all monthly fees until The Summit Medical Fitness Center receives written notice of your intent to cancel once the initial agreement period has been reached.

Facility *


Effective Date of Cancellation (must be the first of the month). Cancellations must be must be received 3 business days prior to the first day of the month. *

Primary Member First Name *

Primary Member Last Name *

Member Number or Scan Code *

Email Address *

Phone Number *

Reason(s) for Cancellation *
Moving Out of Area    Financial    Expectations Not Met - Not pleased with faclity    Expectations Not Met - Not pleased with equipment     Expectations Not Met - Not pleased with staff    Expectations Not Met - Not pleased with programs    Not using facility    Medical    Joining Another Facility    No longer employed by corporation    Too busy    Lack of motivation    Other   

Reasons for Cancellation Other please specify reason

Please rate us on our quality of equipment. (1 = poor, 5 = excellent) *
1   2   3   4   5  

Please rate us on the cleanliness of our facility. (1 = poor, 5 = excellent) *
1   2   3   4   5  

Please rate us on our staff's friendliness, professionalism and knowledge. (1=poor, 5 = excellent) *
1   2   3   4   5  

Please share what you liked most, least and other suggestions to help us improve our services. Thank you.

By typing my name I am hereby giving my written notice of cancellation on the date stated and in accordance with The Summit Medical Fitness Center's Policies and Procedures. *