PAYMENT AGREEMENT & DISCLOSURE
By making a payment to Tampa Bay Body Sculpting (“TBBS”), Patient acknowledges and agrees to the following:
Payments & Refunds
Payments to TBBS secure administrative time, consultation and coordination services, scheduling assistance, and third-party arrangements. All payments are final and non-refundable, including deposits, consultation fees, scheduling payments, and procedure-related payments. If Patient cancels for any reason, all amounts paid are non-refundable.
Surgery Quotes & Pricing
Surgery quotes are valid for three (3) months from the date issued. If Patient reschedules or changes the original surgery date, the procedure will be subject to the pricing and fees in effect for the rescheduled surgery date. Any increase must be paid before surgery. Changes to the procedure, surgical plan, facility, anesthesia requirements, or medical provider recommendations may also change the final price.
Rescheduling & No-Shows
Patient must provide at least fourteen (14) days’ notice to request rescheduling. Rescheduling is subject to availability and approval, and a rescheduling fee may apply. Failure to provide proper notice, cancellation within the required notice period, or failure to appear may result in forfeiture of all amounts paid. Rescheduling does not preserve or extend the original surgery quote or pricing.
Credit Card Surcharge
Payments made by credit card are subject to a 3% credit card surcharge. The surcharge does not apply to debit cards or other eligible non-credit payment methods. Patient may select an available non-credit payment method to avoid the surcharge.
Payment Disputes & Chargebacks
Patient agrees to contact TBBS promptly regarding any billing concern or payment dispute and allow TBBS an opportunity to address the matter. Patient agrees not to knowingly initiate a fraudulent, unauthorized, or improper chargeback or payment dispute for services or obligations that were properly disclosed, authorized, and provided. TBBS reserves the right to pursue recovery of amounts lawfully owed, including reasonable administrative, collection, and legal costs resulting from an improper or fraudulent chargeback.
TBBS Role & Medical Services
Patient acknowledges that TBBS is not a medical provider and does not practice medicine or provide medical advice, diagnosis, treatment, surgery, anesthesia, prescriptions, or post-operative medical care. TBBS provides non-medical consultation, administrative assistance, guidance, scheduling, and coordination services.
All medical evaluations, treatment plans, procedures, anesthesia, prescriptions, and post-operative medical care are provided by independent licensed medical providers and facilities. These providers are solely responsible for medical eligibility, treatment decisions, informed consent, medical services, and Patient outcomes. TBBS does not control or guarantee the medical judgment, performance, availability, results, or outcomes of any medical provider or facility.
Medical Eligibility & Additional Costs
Final medical eligibility and the final procedure plan are determined solely by the treating medical provider. A procedure may be modified, postponed, or cancelled based on medical considerations. Additional testing, medical clearance, laboratory work, medications, garments, post-operative services, or other items may be required and may not be included in the TBBS quote.
Third-Party Providers
TBBS may coordinate services involving physicians, surgical facilities, anesthesia providers, laboratories, financing companies, and other independent third parties. These providers may have separate policies, requirements, fees, cancellation terms, and payment obligations. TBBS is not responsible for charges independently imposed by third-party providers unless specifically stated otherwise in writing.
No Guarantee of Results
No medical or cosmetic procedure has a guaranteed result. TBBS makes no representation, warranty, or guarantee regarding medical outcomes. Questions regarding risks, complications, recovery, expected results, or medical suitability must be addressed directly with the treating medical provider.
Acceptance & Electronic Signature
By signing, electronically accepting, or making a payment after receiving this Agreement, Patient confirms they have read, understood, and agreed to these terms. Electronic signatures and electronic acceptance have the same legal effect as handwritten signatures.
This Agreement is binding upon Patient and Tampa Bay Body Sculpting.