Deposit
Scheduling a surgical procedure requires coordination of multiple resources, including medical staff, operating room availability, and administrative preparation. This planning process requires time and effort to ensure each patient receives proper care and a quality experience. By signing this Invoice of Surgical Fees (the “Agreement”), you acknowledge and understand that Professional Plastic Surgery, Inc. will incur certain administrative and operational expenses in preparation for your procedure(s).
At the time of signing this Agreement, you are required to submit a one-time NON-REFUNDABLE deposit of $250.00 (the “Deposit”) to Professional Plastic Surgery, Inc.
You understand and agree that the Deposit is strictly non-refundable under any circumstances, including, but not limited to, situations in which the patient does not obtain medical clearance, decides not to proceed with surgery, or if surgery is canceled because the patient withheld medical information that was disclosed after submitting the Deposit.
The Deposit will remain valid for one (1) year from the date of payment. If the procedure is not scheduled or performed within that period, additional fees may apply to proceed with this or any other procedure at Professional Plastic Surgery, Inc.
Additionally, if the surgery does not occur within one (1) year from the execution date of this Agreement, the quoted surgical fees may be subject to change.
Payment Terms
You acknowledge that the total price listed above (the “Amount Due”) includes only the services specifically described in this Agreement, such as pre-operative and post-operative visits, laboratory work, and any other items explicitly stated.
Any additional requirements—including, but not limited to, chest X-rays (CXR), mammograms, medical clearances, prescriptions, or other ancillary services—are not included in the Amount Due and must be obtained at the patient’s expense.
The full Amount Due must be paid prior to the scheduled surgery date. Please contact your coordinator to confirm the payment deadline. Failure to pay the full amount by the required date may result in the procedure being canceled or postponed.
You further acknowledge that you are responsible for payment of the Amount Due, as well as any rescheduling or cancellation fees that may apply. If a third party makes payments on your behalf, that individual must also sign this Agreement and accepts financial responsibility for the payments made under this contract.
You understand and acknowledge that all medical procedures carry inherent risks, and results cannot be guaranteed. Payments made under this Agreement are for the medical services provided, not for guaranteed outcomes. Dissatisfaction with surgical results does not entitle the patient to a refund.
If you have concerns regarding your treatment or payments, you agree to contact Professional Plastic Surgery at 305-448-6898 to attempt to resolve the matter before initiating any dispute or chargeback through a financial institution.
If a revision surgery is requested or recommended, additional costs may apply, and such procedures must be paid in full prior to scheduling.
Cancellation Policy
(The date used as valid is the first date listed on the signed contract. If this changes, these terms do not apply, and the Deposit and any other payments will remain non-refundable.)
(a) Cancellation 30 Days or More Before Surgery
If the patient cancels the scheduled procedure 30 days or more before the surgery date, the patient is eligible to receive a refund of the Amount Due minus the non-refundable Deposit.
If the full Amount Due has not been paid, the refund will consist of the amount paid up to that point, less the Deposit.
(b) Cancellation 15–29 Days Before Surgery
If the cancellation occurs 15 to 29 days before the scheduled surgery, the patient is eligible to receive 50% of the Amount Due minus the Deposit.
If the patient completed the pre-operative appointment prior to cancellation, an additional $500 cancellation fee will apply.
Refunds may also be reduced by any expenses already incurred with third-party providers, including but not limited to surgical implants or specialized medical supplies.
(c) Cancellation Within 14 Days of Surgery
If the procedure is canceled within 14 days of the scheduled surgery, the patient acknowledges and agrees that no refund will be issued.
(d) Patients Signing With Pending Surgery Date
If a patient signs this Agreement while the surgery date remains pending, the above cancellation policies do not apply.
In such cases, the Deposit and any additional payments toward the procedure are non-refundable, regardless of whether the patient later decides not to schedule surgery or cancels at a later time.
Refund Requests and Claims
Professional Plastic Surgery has established procedures to minimize disputes, claims, and chargebacks.
Patients wishing to request a refund or submit a claim must contact the Accounting Department by email at [email protected]. Applicable requests will be reviewed and processed within 21 business days. After review, if a refund is approved, it will be issued within a maximum of 60 days.
Entire Agreement
The patient acknowledges that no verbal statements, promises, or guarantees have been relied upon outside of those contained in this written Agreement. Any modification or amendment to this Agreement must be in writing and signed by both the patient and Professional Plastic Surgery, Inc.
Governing Law and Jurisdiction
This Agreement shall be governed by and interpreted in accordance with the laws of the State of Florida. Any dispute arising from or related to this Agreement or the services provided by Professional Plastic Surgery, Inc. shall be resolved exclusively in the courts of Miami-Dade County, Florida, and the patient expressly consents to the jurisdiction of such courts.