ARP WAVE POST SURGERY
ACCELERATED RECOVERY
AGREEMENT
LICENSORS:
DALLAS PEAK PERFORMANCE LLC (Provider)
162 25th St - Miami, FL
AND ARP WAVE, LLC (Licensor)
7721 145th West - Apple Valley, MN 55124
(PLEASE RETURN THE DEVICE TO THIS ADDRESS)
LICENSEE: (Patient or Legal Guardian if the patient is under 18 years old)
NAME:
ADDRESS:
CITY/ST/ZIP
PHONE:
EMAIL:
Date Of Birth:
Social Security Number:
POST SURGERY PROGRAM FEES:
1st Month: $2,000 + Shipping _____________
Shipment Options and Time Frames: Shipping and Handling TO your location (You have to pay the shipping BACK)
Overnight: $200
Overnight with Saturday Delivery: $250
2 Day Ground: $100
3 Day Ground: $50
Shipment Time Frames: For orders placed and paid Monday - Friday BEFORE 6:59 PM EST, the device ships
the following business day (except Saturdays); placed AFTER 7 PM EST, the device ships 2 business days after; Weekend
orders will count as a Monday order and will ship on Tuesday
Program Includes: Accelerated Comfort Program (immediately after surgery) (7 days, aprox)
+ Accelerated Recovery Program: Stage 1 Neuro Therapy (14 days, aprox)
+ Stage 2 Neuro Therapy Training (7 days, 1st part) (this will be done only if stage 1 and 2 are completed)
+ 1 set of sticky pads. Additional sticky pads can be bought for $11 per pack of 4
2nd Month: $1750 (To Be paid 30 days after the 1st payment) ________
Includes: Stage 2 Neuro Therapy Training (7 days, 2nd part)
ARP Wave Neurological Strength Training (14 days)
3rd Month and subsequent months: $1,000 Per month _________ (month to month until you return the device)
PREPAY Month 1 and 2 and save $400: $3350 + Shipping ________
Month 1 Start Date:_______________(the day that you RECEIVE the device) End Date: _______________
PAYMENT INFORMATION ON FILE (to be used AFTER the 2nd full month IF the device is not returned)
Credit Card No:
Expiration:
Security Code:
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Name on the Credit Card:
Billing Address:
This card will NOT be charged unless the device is not return on timely manner.
Please email the tracking number to info@ARPWaveClinics.com to avoid extra charges
ARP WAVE POST SURGERY LICENSE
ARP WAVE, LLC, a Minnesota Limited Liability Company (hereinafter “Licensor") with its principal business address
located 7721 145th West, Apple Valley MN 55124, hereby licenses to, the above listed individual (hereinafter "Licensee")
How The Program Works
ARP Wave on behalf of your doctor or surgeon will supply you for use their proprietary technology called the ARP for use
with the programs you have selected above.
Every day you will interact with your therapist who will instruct you on the therapy you will be doing that day and the therapy
you will do while sleeping. This therapy is done in addition to all other therapy.
This program is the same program the most elite athletes in the world use to recover quickly from surgery and injury.
The Accelerated Comfort Stage: This is a 7 day plan beginning immediately after surgery. This plan focuses on
decreasing swelling and increasing comfort and extends the effects of all current nerve blocks.
Accelerated Recovery Program A Three Stage Program
Stage 1 Neuro Therapy This is a 14 day plan focusing on increasing ROM, eliminating atrophy and neurologically
retraining the muscles to eliminate compensation patterns. This is done in addition to all other therapy.
Stage 2 Neuro Training This is a 14 day plan focusing on neurologically retraining the muscles to absorb force.
Stage 3 Neuro Strength Training This is a plan focusing on neurologically retraining your muscles to be regain strength.
SECTION 1 – SYSTEM LICENSE
1.1.
“System(s)” shall mean the Licensor’s proprietary protocols and programs and all other intellectual property
and equipment associated with ARP Wave LLC, related programs, and related intellectual property. The System(s) and any
and all rights thereto, shall at all times remain the exclusive intellectual and material property of Licensor.
1.2.
Licensor hereby grants and Licensee hereby receives and accepts solely in accordance with the terms and
conditions set forth in this Agreement a non-exclusive license to Licensee for use of the ARP WAVE POST SURGERY
ACCELERATED RECOVERY PROGRAM SYSTEM, which consists of the following:
1.
1.3.
ARP UNIT
The term of this agreement with respect to the System(s) Licensed hereunder shall begin on the date set forth
on page one of this Agreement, “License Start Date,” and shall continue in full force month to month.
1.4.
The System(s) shall at all times be and remain, the sole and exclusive property of the Licensor and the Licensee
shall have no right, title or interest therein or thereto except as expressly set forth in this License.
SECTION 2 – MAINTENANCE AND INSURANCE
2.1.
Licensor shall repair defects to the ARP RX Unit free of charge during the term of this License so long as
the defect does not arise out of misuse or negligence on the part of Licensee. If the required repair is determined to be the
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result of misuse or negligence on the part of Licensee, then Licensee shall be responsible for payment of all costs incurred in
making the repair. If a repair is required, Licensee shall ship the System(s) to Licensor’s facility for inspection and repair as
may be necessary.
SECTION 3 – LICENSEE’S RESPONSIBILITY FOR USE AND CONFIDENTIALITY
3.1
Without limitation, the System(s) are owned exclusively by the Licensor. Licensee acknowledges and
agrees that the System(s) herein licensed are proprietary to Licensor and constitute protocols, programs, trademarks, service
marks, copyrights and trade secrets of Licensor, and title thereto is not conveyed to Licensee and that Licensee’s sole right
and interest in and to the System(s) is the License herein granted. Licensee shall keep all System(s) licensed hereunder
strictly confidential and shall not disclose, display, sell, lease, license, transfer, publish, or otherwise make available the
System(s) to any other party without the written consent of Licensor. The provisions of this paragraph shall not be deemed
to derogate or lessen responsibilities set forth in any other provision hereof or available at law.
3.2
The standard indications approved by the FDA for use for the ARP Unit under 21 CFR 890.5850 are:
Relaxation of muscle spasms; Prevention or retardation of disuse atrophy; Increasing local blood circulation; Muscle reeducation; Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis; and Maintaining or increasing
range of motion. Federal law restricts the ARP Unit to sale or lease by or on the order of a practitioner licensed by the
law of the State in which he/she practices to use or order the use of the Unit. Licensee, by signing below, acknowledges
that he/she has obtained a prescription for the use of the ARP Unit from a licensed practitioner sanctioned by Lessor. Licensee
agrees not to use the ARP RX System(s) on, or allow its use by, any third parties.
3.3
Without limitation to any other provision hereof, if this Agreement is terminated upon Licensee’s default,
or upon any other termination of this Agreement, it is hereby agreed that any rights herein set forth shall be deemed to be
automatically revoked and automatically reassigned to Licensor.
3.4
Upon termination of this Agreement for any reason, Licensee shall immediately return to Licensor all
equipment subject to this agreement.
3.5
The Licensee/Licensee agrees to use each and every ARP UNIT only in accordance with the protocols
licensed hereunder and to strictly abide by the instructions given by the concierge.
3.6
Licensee shall keep the System(s) Licensed hereunder free from all liens, security interests and encumbrances
of any nature whatsoever.
3.7
Should the Licensee fail to pay any portion of the rent herein reserved or any other sum required by the
Licensee to be paid to the Licensor within ten (10) days after the due date hereof, the Licensee shall pay unto the Licensor interest
on such delinquent payment from the expiration of said ten (10) days until paid at the highest rate permitted by the laws of the
state whose laws govern this Agreement, but not to exceed 8% per annum.
3.8
This License constitutes the entire agreement between the parties hereto; and this License shall not be modified,
amended, altered, or changed except by a written agreement signed by the parties hereto.
3.9
THIS LICENSE AGREEMENT IS MADE WITH REFERENCE TO AND SHALL BE GOVERNED
AND CONSTRUED EXCLUSIVELY BY THE LAWS OF THE STATE OF MINNESOTA, WITHOUT REFERENCE TO
ITS CONFLICTS OF LAWS PROVISIONS. EACH PARTY CONSENTS TO THE JURISDICTION OF ANY STATE OR
FEDERAL COURT LOCATED WITHIN THE COUNTY OF HENNEPIN, STATE OF MINNESOTA AND
IRREVOCABLY AGREES THAT ALL ACTIONS OR PROCEEDINGS RELATING TO THIS AGREEMENT OR ANY
RELATED AGREEMENTS MUST BE LITIGATED IN SUCH COURTS. EACH PARTY ACCEPTS FOR ITSELF,
GENERALLY AND UNCONDITIONALLY, THE EXCLUSIVE JURISDICTION OF THE AFORESAID COURTS AND
WAIVES ANY DEFENSE OF FORUM NON CONVENIENS. EACH OF THE PARTIES HERETO HEREBY WAIVE
THEIR RESPECTIVE RIGHTS TO A JURY TRIAL OF ANY CLAIM OR CAUSE OF ACTION BASED UPON OR
ARISING OUT OF THIS AGREEMENT.
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7.11.
If any provision of the License is held to be unenforceable, the remainder of the License shall not be affected
thereby but shall remain valid and enforceable. If any provision of this License is so broad as to be unenforceable, such
provision shall be sufficiently narrowed so as to make it enforceable.
WHEREAS, THE UNDERSIGNED HAVING READ THE ABOVE TERMS AND CONDITIONS AND AGREEING
TO BE BOUND BY THE ARP WAVE RX SYSTEM LICENSE AGREEMENT PRESENTS THEIR SIGNATURE
BELOW ON THIS ____ DAY OF _______________ 2014
By:______________________________________Date:__________________________
Paula Wallem, Dallas Peak Performance LLC Member, official ARPWave Provider
LICENSEE/LICENSEE
By:______________________________________Date:__________________________
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