Cancellation Policy

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Date of Consent *

SILVER SOLUTIONS MEDSPA POLICIES & GENERAL CONSENT

Please sign below to indicate that you have read and agree to each policy.

Appointments (Initial below) *

Please be aware of our policy regarding missed appointments and late cancellations. If cancellation is necessary, we require that you call at least 24 hours in advance. A cancellation is considered late when the appointment is canceled less than 24 hours before the appointed time and a $50 cancellation fee will be charged. A no-show is when a patient misses an appointment without canceling and a $100 no-show fee will be charged. Missed appointments and late cancellations without 24-hour cancellation will be charged according to our cancellation policy and the card on file will be used to charge the appropriate fee. I agree and authorize Silver Solutions MedSpa to charge my credit card for no-show appointments and late cancellation fees.

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Prices/Services/Payments/Refunds/Returns (Initial below) *

Our medical spa is limited to elective aesthetic medicine and thus we do not bill insurance. Payment for all individual treatments is due on the day of treatment unless other arrangements are discussed. All packages must be paid in full prior to the time of the first treatment. All prices are subject to change without notice.

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Advanced Care Credit (Initial below) *

We offer financing through Advanced Care Credit (apply on our website silversolutionsmedspa.com). We conveniently accept cash (no discount for cash payment), Silver Solutions Gift Cards, Visa, Mastercard, Discover and American Express.

Although we make every effort to keep you advised of all price changes and increases, please note that prices, services, and products are subject to change at any time and without notice. We encourage all patients to inquire about pricing and available services when booking an appointment.

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All services are final sale (Initial below) *

All services are final sale. WE DO NOT GIVE REFUNDS ON ANY SERVICE. We do not offer refunds on services rendered, even if you are disappointed with the result or outcome. We do not offer cash refunds on purchased products. Products may be returned for in-spa credit provided the product is returned within 14 days from the date of the purchase with a receipt and there is a documented allergic reaction to the product. Defective products (ie. a broken cap) may be exchanged within 14 days of purchase for the same products only, with a receipt. In accordance with federal law, we do not offer refunds or exchanges on prescription products for any reason.

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Revisional Treatment or Treatment Complications (Initial below) *

The practice of medicine and medical aesthetics is not an exact science. Although good results are anticipated, there can be no guarantee, express or implied, by anyone as to the actual results you may achieve. We will always strive to achieve the absolute best result that we can for you. Occasionally additional treatments and/or treatment for problems or complications may be required. These could result in additional charges for which you may be responsible. Your insurance, if you have it, may or may not cover the expenses related to actual complications or other medically related problems arising out of your treatment.

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Photo Consent *

I authorize the use and disclosure of my name, photo-graphic/video images, and/or testimonial for charting, educational and marketing purposes by Silver Solutions MedSpa. I understand that information disclosed pursuant to this authorization may be subject to redisclosure and may no longer be protected by HIPAA privacy regulations. The photographic/video images, and/or testimonial will be used for: charting, educational Purposes, social media and/or Advertising.

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Patient Signature *

The above contains the entire Silver Solutions MedSpa policies and general consent. These policies supersede any prior policies, agreements, understandings, negotiations, whether written or oral. These policies can only be amended throughout a written document formally executed by all parties.

By Signing below, I acknowledge that I have read all the details in the above policy and consent form and will receive a copy of this form in email after it is signed.

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Cancellation Policy