General and Financial Policies

HIPAA

  • I acknowledge receipt of RSMD Medical Spa’s Notice of Privacy Practices.

  • I acknowledge that the office of Dr. Rebecca Small is not responsible for messages sent to telephone numbers and/or email addresses supplied by you that may be shared with others or you no longer own.

OPEN PAYMENTS DATABASE

  • For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologicals to physicians and teaching hospitals be made available to the public.

  • You may search this federal database for payments made to physicians and teaching hospitals by visiting this website: https://openpaymentsdata.cms.gov/

MEDICAL INFORMATION

  • I acknowledge that it is my responsibility to fully and accurately disclose my medical history including but not limited to: medical conditions, medication allergies, use of medications and supplements, sun exposure and to inform and update the RSMD Medical Spa health care professional treating me of my current medical history at each visit. Failure to do so may affect treatment results and increase the likelihood of complications.

  • I also accept responsibility for adhering to the before and after instructions for all of my treatments.

  • I am aware that RSMD Medical Spa does not accept or provide any billing services for any type of insurance or third-party payer and all payments for services are my personal responsibility and due prior to or at the time of treatment.

  • I understand that I need to contact Dr. Small/RSMD Medical Spa directly by phone at (831) 475-1077 for any medical questions, problems, or concerns relating to my treatment or to change my appointment time.

  • I understand that my treatments will be performed by one of RSMD Medical Spa’s licensed providers which may include a doctor, a nurse, or an esthetician when appropriate.

FINANCIAL

  • Treatment series must start no later than 3 months from date of purchase and be completed within 12 months from the date of the first treatment. Unredeemed treatments expire 12 months from the date of purchase.

  • Prices quoted at the time of treatment supersede all other price quotations written or verbal and are subject to change at any time.

  • No refunds will be issued. However, at RSMD Medical Spa’s discretion, the credit balance for unredeemed treatments in a LASER (where LASER includes laser and intense pulsed light) series may be transferred to other LASER treatments after the redeemed treatments are prorated at the regular undiscounted price.

  • Consultation fees are nonrefundable and must be redeemed 30 days from the date of consultation.

LATE ARRIVALS, CANCELLATION AND MISSED APPOINTMENT

  • Cancellations and changes with less than 48 hours notice or missed appointments may incur a fee of $50 for the first occurrence. Subsequent occurrences will incur a fee of $150, or if your treatment is part of a series, your treatment will be forfeited.

  • If you are more than 15 minutes late, your treatment will be rescheduled or forfeited at RSMD Medical Spa’s discretion.

RSMD Medical Spa reserves the right to modify these policies and treatment prices at any time without notice. These policies supersede all prior MBLA/RSMD Medical Spa policies, whether written or verbal. By acknowledging this Agreement, the patient confirms that they have fully read and understand its contents, have had the opportunity to ask questions, and agree to the policies of RSMD Medical Spa.