Surgery Scheduling Fee

Elective Procedure Booking: Terms & Conditions

1. Elective Procedure & Insurance

• The procedure you are scheduling is elective (optional) and cosmetic.

• Cosmetic procedures are typically not covered by health insurance.

• We will not bill your insurance for this service. All charges are billed directly to you.

• You are fully responsible for the entire cost of the procedure.

2. Non-Refundable Deposit

• A non-refundable deposit is required to reserve your appointment time.

• This deposit secures your booking and will be applied towards the total cost of your procedure.

• If you cancel your appointment or choose not to proceed for any reason, this deposit is non-refundable and will be forfeited.

3. Cancellation & No-Show Policy

• Cancellation: If you cancel your appointment for any reason, your non-refundable deposit will be forfeited. Cancellations made with insufficient notice may incur additional fees according to our policy.

• No-Show: Failing to attend your scheduled appointment without prior notification is considered a cancellation, and your deposit will be forfeited.

• Clinic Cancellation: If we (the clinic or surgeon) must cancel or postpone your procedure (e.g., due to an emergency), we will notify you as soon as possible. We will offer to reschedule your appointment or provide a full refund of your deposit.

4. Rescheduling Policy

• You may reschedule your procedure once without losing your deposit, provided you give us sufficient advance notice (e.g., at least 14 days prior). Your deposit will be applied to the new appointment date.

• Requests for multiple rescheduling changes, or rescheduling with insufficient notice, may result in:

  • Forfeiture of your original deposit.

  • Requirement of a new deposit for the rescheduled appointment.

  • An additional re-booking fee.

• Last-minute rescheduling may be treated as a cancellation (deposit forfeited). We will strive to accommodate reasonable rescheduling requests within these guidelines.

5. Doctor-Patient Relationship

• Booking an appointment and paying a deposit does not automatically establish a doctor-patient relationship.

• A formal relationship begins only after an in-person consultation and evaluation by the surgeon, confirmation that the procedure is appropriate for you, and mutual agreement to proceed.

• The surgeon reserves the right to decline performing the procedure if it is deemed medically inappropriate or unsafe during the consultation. In such cases, your appointment will be cancelled, and your deposit will be refunded (or potentially applied to consultation fees or alternative treatments, if applicable).

• Booking does not guarantee that the procedure will be performed.

6. Financial Responsibility & Cost Adjustments

• You acknowledge full financial responsibility for the cost of this elective procedure.

• Changes in your insurance coverage or denial of any insurance claim you might submit do not affect your obligation to pay the full amount, nor do they warrant a refund of the deposit.

• All quoted prices are estimates. The final cost will be confirmed after your medical evaluation.

• Your treatment plan and associated costs may be adjusted based on the consultation findings or if additional services become necessary. We will inform you of any significant changes in advance.

• The clinic is not liable for discrepancies between estimates and final costs or for cost changes resulting from adjustments to your treatment plan.

Acknowledgment

By placing your deposit and scheduling this procedure, you confirm that you have read, understood, and agree to abide by these Terms and Conditions. This includes the policies regarding insurance, financial responsibility, non-refundable deposits, cancellations, and rescheduling.