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Studio Liability Release
TREATMENT AND FINANCIAL AGREEMENT TERMS, CONDITIONS, DISCLAIMERS AND REFUND POLICY (EFFECTIVE 4-14-2010)
• I fully understand and agree to treatment of the listed areas, and agree to pay American Laser Centers the price quoted above
• If I have paid the price quoted using a credit program, I acknowledge that I have selected the credit program based on my own evaluation of my options. I have not relied on any recommendation or advice of American Laser Centers or its staff with respect to financing. I understand that American Laser Centers has agreements with credit program providers but does not recommend credit products to customers
• I clearly understand that my payment is for the procedure(s) performed during the term of the agreement and not for any specific result. NO RESULT IS GUARANTEED. I understand that results will vary
• Additional treatments may be obtained at an additional price
REFUND, CANCELLATION & TRANSFER CREDIT POLICY
THIS POLICY WILL BE VOIDED IF YOU TRANSFER SERVICES TO ANOTHER LOCATION AND WILL BE REPLACED BY THE RECEIVING CLINIC’S CURRENT POLICY
Your payment is based on purchasing number of treatments. Refund is based on unused treatments not based on unused time. e.g. Laser Hair Removal Series – Your payment is based on purchasing 6 treatments. NOT 2 yrs. In the 2 yr appearance plan phase (after your 6th treatment), we reserve the right when to treat you and how many times to treat you. If you receive 6 treatments, no refund is due. All refund prorating will be based on unused treatments. There is no prorating for time. e.g. If you purchased a package of 6 and received only 4 treatments in 8 months and request a refund. You have 2 unused treatments and 16 months left before your 2 yr appearance plan expires. A prorated refund (see below) will be given for 2 unused treatments, NOT based on remaining 16 months.
If you want to cancel services and want refund – You WILL BE charged FULL PRICE PER TREATMENT of the procedure. The price per treatment of the procedure you purchased is on our price list sheet and will be provided to you on request. All discounts (e.g. monthly specials) and credits issued when you bought the service will be lost. Service will be prorated using price per treatment listed on the price list sheet. If you earned friends and family credit - this will be LOST if you cancel/break this agreement. A prorated balance will be refunded
If you want to cancel services and don’t want a refund but want to transfer credit to another package – You will NOT be charged FULL PRICE per treatment of the procedure to calculate prorated balance. You will be charged the price per treatment based on your package. The balance will be used towards a new package. You will be eligible for the month’s special etc. If this results in you owing money, you can pay the difference and start the new package. If this results in us owing you money, this will be kept as credit for future use. (Credit expires 90 days from new purchase).
If you don’t see results even after 2 yrs of treatments for Laser Hair Removal - NO REFUND is due. You can buy a new package at 2 yr appearance plan (maintenance) price.
If you are burned or have other adverse event – NO REFUND is due. This is part of the risk of the procedure and was explained to you when you signed the contract. Our goal is to eliminate/minimize the risk of burn or any other adverse event, but we want to be upfront with you so you can make a well informed educated decision.
Other Fees –
No Show Fee - $75. If you do not show up for your scheduled appointment
Cancellation Fee - $75. If you cancel appointment without giving us a 24hr notice
Shaving Fee - $75. If you come in without shaving (exception – first treatment or unless we asked you not to shave)
Photocopying Fee - $10. For a copy of your records. Need a written request
I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE.




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