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MACKAY

MEMBERSHIP CANCELLATION REQUEST

Please complete this form to begin your membership cancellation request. Completion of this form does not confirm your membership has been cancelled - this is a request form.

Fill out this form
We’ll be in contact to provide the final cancellation requirements upon viewing your membership
You will have access to the centre until the cancellation notice period has ceased.

*30 days' notice applies to all memberships, cancellation fees and contract payouts may be applicable.

First Name

Last Name

Phone

Member Number (if known)

If we, were able change your mind, what would help you stay as a member?

Do you have any feedback for our Centre?

I agree to the terms & conditions - By submitting this form, I am giving Avanti Health Centre my written notice to cancel my membership per my membership agreement. Should I choose to rejoin Avanti Health Centre after the termination of my membership, I will have to pay at the then current rate. I am submitting a notice of cancellation as required per the membership agreement and understand a cancellation period may apply. I understand that cancelling my membership during a contract period will result in a cancellation fee as agreed upon in the membership agreement. This fee will be applied immediately and my membership will be deactivated at the end of the last agreed payment prior to the cancellation

Your Signature

Your cancellation request has been successfully submitted. We are sorry to see you go and would love to see you remain as a member. Our customer care team will action your request and be in touch within 48 hours

MACKAY

MEMBERSHIP CANCELLATION REQUEST

AVANTI HEALTH CENTRE PORTAL

QUESTIONS? EMAIL NATALIE.WILLIAMS@AVANTIHEALTHCENTRE.COM.AU