Physician Alliance Agreement - Xtreme Total Health and Fitness

Physician Alliance Program Application

I, ______________________________________ have reviewed the Xtreme Total Health & Fitness Physician Alliance Program and wish to participate as an Alliance member. As an Alliance member I can expect to receive the following benefits:

One month Free Membership to Xtreme Total Health & Fitness

Continued Monthly Membership for each referral that signs a PT package

Free Body Composition & Fitness Assessment

Two free Personal Training sessions for the participating physician

Two free Personal Training sessions for one member of the medical staff

A 10% discount for the entire staff on Personal Training services

A 2- week free membership to Xtreme Total Health & Fitness for the staff

As an Alliance member I understand my responsibilities to include the following:

Display agreed upon Personal Training marketing materials in office

Actively refer patients in need of better health to Xtreme Total Health & Fitness

Actively promote personal training and the services offered by Xtreme Total Health & Fitness

This alliance is intended to promote better health, preventive medicine and awareness of total fitness. The alliance is a win/win partnership based on a common goal of improved health and fitness for the general public.
By signing this agreement neither party has a legal obligation to the other, but promises to make "best effort" in executing the program features described above. Please sign and fax back to The Xtreme Team, 813-258-8551. Once we receive the signed program participation form we will issue the free membership passes and schedule the free PT sessions.

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Physician's Signature

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Toni Derby Xtreme Total Health & Fitness, General Manager