Payment Authorization

By accessing the Kinex Medical Company, LLC payment services and site, you agree to be bound by the terms below and authorize at Kinex Medical Company, LLC, its affiliates and their successors, assigns, directors, officers, managers, employees, agents, service providers and/or authorized representatives (collectively, “Kinex Medical”, “us”, “we”, or “our”) to establish and maintain your payment authorizations and to process your payments according to your instructions.

1. PAYMENT TERMS: You hereby authorize Kinex Medical to debit your account from a bank or financial institution and/or charge your debit or credit card according to the instructions you have provided us (the “Payment Instructions”), which are available for your review at https://kinex.mypatient acct.com. It is your responsibility to establish and maintain your account and/or and to pay any and all fees associated with your account. We will process your payment on your selected payment date. However, if we are not open or have technical difficulties, we will process your payment on the next available day. All payments are subject to further verification and payment, and to the terms and conditions for your accounts and/or debit or credit card agreements.

2. ONE-TIME PAYMENT AUTHORIZATION: If your Payment Instructions specify a one-time payment, you authorize us to make a one-time debit from the account and/or charge your debit or credit card and in the amount specified in your Payment Instructions on or after the date indicated in your Payment Instructions. You understand that returns, refunds and cancellations may be subject to fees and penalties imposed by your bank, financial institution, or debit or credit card company. You certify that you are an authorized user or owner of the provided account to be debited or debit or credit card to be charged.

3. RECURRING PAYMENT AUTHORIZATION: If your Payment Instructions specify a recurring payment, you authorize us to regularly debit from the account or charge your debit or credit card and in the amount specified in your Payment Instructions on or after the dates indicated in your Payment Instructions. You understand that returns, refunds and cancellations may be subject to fees and penalties imposed by your bank, financial institution, or debit or credit card companies. You understand that this authorization will remain in effect until the last scheduled payment date, unless you cancel this authorization pursuant to the terms contained herein. You certify that you are an authorized user or owner of the provided account to be debited or debit or credit card to be charged.

By authorizing this recurring payment, you agree to maintain sufficient funds in your account to cover each payment requested. We reserve the right to terminate your participation in this automatic payment program at any time and in our sole and absolute discretion. You must notify us if: (a) any information changes regarding your account or debit or credit card (b) if you wish to change the account or financial institution for which your payment is debited or the debit or credit card to be charged, or (c) if you wish to stop a payment or discontinue your participation in the program. In the event that you discontinue your participation in recurring payments, the request will go into effect the next billing cycle. Please note that your request to discontinue recurring payments does not relieve your obligation to pay any current or future invoices by the due date.

4. REVOCATION OF AUTHORIZATION AND/OR CANCELLATION OF PAYMENT: You may cancel or edit any scheduled payment by accessing your account at Kinex.mypatientacct.com or by calling us at (262) 521-7381 during our business hours at least one (1) business day prior to the scheduled payment date, and you will not incur a charge for canceling or editing the payment. You understand and agree that once we have begun processing a payment, it cannot be canceled or edited by us. Additionally, cancellation or modification of a payment does not relieve your payment obligation.

5. PAYMENTS NOT PROCESSED: Kinex Medical is not responsible for any failure to process Payment Instructions that are not actually or completely received by Kinex Medical for any reason, including, without limitation, user error, equipment malfunction, natural disasters or other circumstances beyond Kinex Medical’s reasonable control, insufficient funds in your account, or inaccurate or incomplete information.

6. BANK OR FINANCIAL INSITUTION LIMITATIONS: If your bank or financial institution and/or debit or credit card company are unable to process your Payment Instructions, the payment may not have been made. There may be limits or restrictions upon the number or frequency of payments that may be made from your account under applicable law or under the terms of your agreement with the bank or financial institution maintaining your account or by your debit or credit card company. Kinex Medical’s obligations are subject to any such limits or restrictions and Kinex Medical has no duty to notify you of any non-payment, or any such limits or restrictions.

7. GENERAL CERTIFICATIONS: You certify that you are at least eighteen (18) years of age, that you are the holder of the account designated by you for payment and that you are authorized to consent to this authorization and agree to this authorization.

8. ELECTRONIC AUTHORIZATION CONSENT: When you make an automatic recurring payment arrangement, we are required by law and regulation to provide you with a writing describing the terms of that payment arrangement. To use this online service, you must agree to receive the terms of the authorization and any other communication or disclosures with us electronically now or in the future, including disclosures required by state or federal law. You also agree that your electronic acceptance of the terms of the authorizations will constitute a valid and binding electronic signature that will have the same force and effect as a handwritten signature by you. If you do not agree to your use of electronic signature, you must not use this Service and immediately exit the Site.

Hardware and Software Requirements
To access and retain the information subject to this consent, you must have or have access to equipment that meets the hardware and software requirements:
• Windows operating system or Macintosh OS X.
• Internet access and an internet browser which supports HTML 4.0, SSL encryption, Cookies and JavaScript.
• Adobe Reader.
• For Windows users, the latest version of one :
.       o Microsoft Edge
.       o Mozilla Firefox
.       o Google Chrome
• For Macintosh users, the latest version of:
.       o Apple Safari
.       o Mozilla Firefox
.       o Google Chrome

To print the Payment Authorization, communications or any other documents you must have a printer connected to your computer. To download the Payment Authorization, communications or any other documents, you must have sufficient hard drive space to store the relevant materials.

By consenting to this Electronic Authorization Consent disclosure, you agree that you have the requisite hardware and software requirements as described above. If, in the future, you no longer have access to a computer that meets the hardware and software requirements, would like to revoke this electronic authorization consent, please contact us at by calling us at (262) 521-7381 during our business hours. Our business hours are Monday through Friday, 8 a.m. to 5 p.m. Central Time zone excluding federal, state and local holidays.

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