NEW PATIENT FORMS

New Patient Information (3 pages)
New Patient Financial Policy (2 pages)

SPA ETIQUETTE

For the comfort of all guests, please turn off cellular phones, laptops and pagers prior to entering the spa. Your provider may terminate the service, without refund, if inappropriate language or actions occur.

For safety reasons, the maximum occupancy of each spa room is three people. Anyone accompanying you to your spa services is welcome to wait in the front lobby. Children under 12 may not be left unattended; you will need to reschedule your appointment should your children come with you to the spa.

LATE ARRIVALS AND CANCELLATIONS

We require a credit card number to hold all appointments. This may be waived. In the event that you need to cancel your scheduled appointment with us, we do require at least 24 hours notice. In the case of a same day cancellation or if you fail to show up at your scheduled appointment time, you will be charged a $40 fee for your missed service. This is as a courtesy to the staff member, and so that we may possibly accommodate the needs of other clients. However, we understand that emergency situations do arise and we will accommodate you if at all possible.

If you arrive late, the length of your treatment will be reduced to end as scheduled, allowing the provider to take their next scheduled appointment on time. If you must cancel, please call 24 hours in advance to avoid the cancellation fee.

APPOINTMENT REQUESTS

Every effort is made to accommodate your request to see specific staff members but we cannot guarantee that you see the same provider for all treatments.

FINANCIAL POLICIES AND INFORMATION COLLECTED

Because we provide elective cosmetic procedures, the care provided at Synergy Wellness & MediSpa is not covered by any medical insurance programs, and we do not participate in any such plans.

Some of the content and medical spa services available in our location and on our website require registration. We may collect contact information (including name, phone number, mailing address, e-mail address, etc.). We may use this information to contact you if the need arises and to send you information about our company and promotional material. You always have the right to opt out of receiving such mailings. Your credit card information may be stored by our client management partner, Stripe, Inc. Credit card transactions are handled by our payment processing partner, CardConnect. We reserve the right to change our client management partner or our payment processing partner at any time and without notice so you should check back with us regularly if this is a concern to you. We reserve the right to use the stored credit card information to pay for continuing or recurring memberships, no show / late arrival fees, and outstanding balances on the client’s account.

PAYMENT OPTIONS

Payment for all medical spa procedures is due at the time of the treatment. For specialty packaged or grouped treatments, payment for the entire package is due at the time of the first scheduled treatment.

A credit card is required to reserve an appointment for treatment scheduled in advance. A $50 charge (cash or credit card) is due at the time of the booking to secure the appointment. This may be waived. We provide a number of payment options which may be used individually or combined according to your desires.

CASH

MAJOR CREDIT CARDS

Visa, MasterCard, American Express and Discover

INTEREST-FREE FINANCING

CareCredit® and LendingUSA™

CANCELLATION AND REFUNDS

We understand that a situation may arise that could force you to cancel or postpone your treatment. Please understand that such changes affect not only our staff but our other patients as well, and we therefore request your courtesy and concern. If you need to cancel your appointment, please allow 24 hours to notify us of the cancellation. Should we receive less than 24 hours of notification, or should you fail to keep your appointment, you shall be charged a $40 cancellation fee. If you arrive late, the length of your treatment will be reduced to end as scheduled, allowing the provider to take their next scheduled appointment on time. If you must cancel, please call 24 hours in advance to avoid the cancellation fee.

THERE CAN BE NO REFUNDS FOR SERVICES ALREADY PROVIDED

In the event that a package or series of treatments has begun, these services will be considered to have been rendered even though the full series may not have been completed. Should you wish to discontinue your treatment in the midst of a series, credit for the pro rata share of unused treatments at the discounted package price may be extended, and this may used to purchase other treatments or products offered by Synergy Wellness & MediSpa, or it may be transferred to another individual to be used in exchange for treatments or products of comparable value to the credit.

There are no refunds for products or services. Credit may be extended for other services to you or another individual. Returns are not accepted for prescription products.

REVISIONAL TREATMENT OR TREATMENT OF COMPLICATIONS

The practice of medicine and surgery is not an exact science, and medical spa treatments are the practice of medicine. Although good results are anticipated, there can be no guarantee or warranty, expressed or implied, by anyone as to the actual results you may get. 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 treatment at Synergy Wellness & MediSpa.

*These Financial Policies are subject to change without notice. If you have any questions or need assistance with any financial matters relating to your treatment, please contact the Medical Spa Coordinator for help.