Office Policy
Disclosure of Medical History – I agree that I will disclose a full and accurate personal medical history, including any and all information regarding medical conditions and my use of medications, drugs, herbs, vitamins or other supplements of any kind. I understand that failure to do so may affect my treatment outcome and increase the likelihood or severity of complications.
Confidentiality – I understand that no information regarding services performed shall be released without my express consent except as follows: I authorize that copies of my records may be sent to another location if I seek additional treatment at that location. I understand that, in addition to authorized clinic personnel, the clinic’s medical director and consulting physicians shall have full access to my treatment records. I understand that appropriate medical review may be conducted to further the safety and efficacy of my practitioner’s services. I understand my practitioner may also provide limited patient information to various third-party vendors to provide database development and maintenance services, referral services or marketing research services. My practitioner will maintain file copies of all records for a minimum of three years.
Scheduling appointments- Scheduling of appointments can be done thru the website or by calling the spa at 813-797-0167. In order to complete the scheduling of your appointment, a credit card must be placed on file. Those who are not willing to place a credit card on file will not be allowed to schedule for any service.
Photo Consent – I understand that photographs are required for treatment and will be taken to document treatment results in my medical record, but they will not be released or used otherwise without my specific written consent. I authorize the taking of photographs before, during, and after my treatments and procedures.
Payment- Payment is due at the time of service. We accept credit cards and cash. No personal checks will be accepted. We also offer Cherry financing.
Cancellation Policy – I agree to contact my practitioner at least 24 hours in advance if I need to cancel or reschedule my appointment. I understand that I will be required to pay a missed appointment fee of $50. I understand that if I arrive more than 10 minutes late for my appointment, I may be required to reschedule in order to avoid disrupting the appointments of other patients.
Price Quotes – Pricing quoted in a consultation will be honored for 14 days only. After 14 days, pricing will expire. An updated consultation and treatment pricing can be provided, upon request, at no charge.
Sales of Services – All Medical Spa service sales are final. If there is a valid medical reason as to why you cannot utilize the Medical Spa service that you purchased, we will allow you to use your remaining balance towards other services of equal value. The only time that we will provide a refund for your purchase of a Medical Spa service, is if your complaint is accompanied by a practicing physician’s note explaining your medically-inclined inability to utilize the service within 6 months of the purchase date of said service, at which point we will present you with a 50% refund of the original service purchase price.
Return Policy – In the event that there is an allergic reaction to the product you purchased from us, you may return it within 14 days of the original purchase date with a valid receipt for a full refund if you purchased the product after consulting with one of our skin care specialists.
Insurance Reimbursement – I have been notified and fully informed that the procedure to be done is a cosmetic procedure as defined by the insurance industry. I understand that cosmetic procedures/services are determined to be “not medically necessary”. This procedure cannot be filed with any insurance company for payment or reimbursement by myself or any other party. I hereby agree to be held personally and fully responsible for payment of entire procedure at the above cost/expenses at the time of service.
Guests and Children – I understand that children and guests are not permitted in any procedure room for any reason due to significant medical and safety risk. Children under 12 years old are not permitted unattended in the waiting room at any time. Staff members are not permitted to supervise children. No pets are allowed unless they are a service animal.
Results – I understand that cosmetic procedures are not an exact science. Although our staff strives for the best results with all treatments, the efficacy may vary among individuals. I understand that I may see excellent results, partial results, or no results. Refunds will not be requested or expected by me.
Promotions – On occasion we offer promotions. Promotional pricing is valid during the time specified only and may not be combined with other offers. Promotional products and treatments have no monetary value and may not be exchanged, including packages and free product.
Purchase of Service Expiration – I understand that the purchase of ALL services and/or treatments, including but not limited to, pre-paid Botox units, filler syringes, laser, chemical peels, and all packages, expire exactly 1 year from the date of purchase. No refunds will be given for services or treatments that have not been used within that year.
Skin Care Products – I understand that some of the skin care products offered by my practitioner are professional strength and formulated to aggressively treat problem skin. I agree that I will use any skin care products obtained from the clinic in accordance with the instructions and directions provided to me by the clinic staff and only after becoming acquainted with the product and its recommended use. I realize that I may experience varying degrees of discomfort, redness, burning, peeling, itching, dryness or other symptoms, especially in the early stages of use. These symptoms should lessen and eventually subside as my skin tolerance develops. I understand that in unusual circumstances, use of these professional strength products could be harmful and even cause injury to the skin (infection, discoloration, superficial scarring, etc.). I will discontinue use and notify my practitioner immediately if any unusual or concerning irritation occurs. I will not use any of these professional strength products if I am nursing, pregnant or trying to become pregnant. I understand that long-term use is necessary to achieve and retain the de