Intake Form
















Due to the membership nature of our business time slots contain fiduciary value. Appointments must be cancelled or rescheduled, by phone, no later then the end of business day before the treatment scheduled date. A cancellation fee of $25 will automatically be assessed for each half hour blocked on the schedule 15 minutes after the scheduled appointment time in the event of a no-show or late cancel.

If I am 15 minutes late to my appointment or do not call to reschedule my appointment the day before my appointment is scheduled, my appointment is considered missed and I will be charged a $25 no-show / rescheduling fee for each half hour blocked on the schedule.

Skin Body Soul Med Spa will do everything to accommodate you, however, Skin Body Soul Med Spa cannot guarantee a time slot if greater than 15 minutes late.




Skin Body Soul Med Spa is committed to providing an excellent experience for each patient producing results. If for any reason you are unsatisfied with our service, we offer a full refund on any non-discounted retail products or services. All Full Priced Service Packages & Retail Products purchased are valid for full refund within 30 days of purchase.

Any discounted products, packages and individual services purchases below retail price are eligible for EXCHANGE ONLY and are otherwise non-refundable. Discounted or promotional packages and services, such as services or products purchased through third parties such as: Groupon, Amazon Local, Livingsocial, or any other third party must be refunded through those third party vendors directly.

Because of substantial investment in equipment, time and resources, all memberships are substantially discounted from retail price and sold as a contracted amount. Memberships are refundable only if a health condition arises causing the patient to no longer be serviceable. Please see membership agreement for more details regarding individual membership termination, transfer, upgrade or downgrade options. Memberships are otherwise Non-Refundable however, memberships may be upgraded, downgraded, or placed on hold for 60 days max at anytime with 30 days notice after the initial 60 day signup period has transpired. Hold fees may apply.














PATIENT CONSENT AND ACKNOWLEDGEMENT

  1. I acknowledge that the doctors, aestheticians and fully licensed staff at Skin Body Soul have clearly explained all medical and nonmedical technology prior to engaging in any service.

  2. I Understand that Skin Body Soul acts as a "collective buyers group" (membership) and all medical treatments performed on premises are performed under the supervision of a physician, a physician's standing order, or by the medical director directly.
  3. With my signature below, I give my consent to receive a treatment protocol as prescribed by my physician or as described on the price list page, membership benefits contract, or prepaid packages purchased if non-medical service. I acknowledge that all of my concerns and questions have been expressed competently and thoroughly. Questions have been answered by the staff at Skin Body Soul. I understand the objectives of any programs suggested.
  4. I acknowledge all medically based procedures will have an additional intake and consent form provided by the physician. No treatments will be considered prior to a medical history form and additional patient consent form as provided to you by a Skin Body Soul team member.
  5. While it is expected that we will meet our objectives for my improvement, I also understand that if I have a chronic condition my results may vary.
  6. I understand and agree that by participating in any program successfully is contingent upon me following advice as reasonable instructed by the doctor or licensed staff at Skin Body Soul. In the event I fail to follow the reasonable instructions of the doctor & staff, alter the treatment schedule as originally designed by the doctor or staff or do not attend scheduled laser treatments this will alter the outcome of the treatment program.
  7. I agree that Skin Body Soul may/can terminate my treatment plan at anytime.
  8. I agree my consent and authorization for this or any procedure at Skin Body Soul is strictly voluntary. By signing the informed consent form I grant authority for the doctors and fully licensed staff at Skin Body Soul to perform the described treatment or administer any related treatments as deemed necessary or advisable for any medical or non-medical condition. Skin Body Soul Med Spa, any of its staff, officers, members, or affiliates have made no guarantees as to the results that may be obtained by any treatments.
  9. I have read this informed consent and certify that I understand its contents in full. I have had enough time to consider the information and feel I am sufficiently advised to consent to this procedure. I hereby give my consent to have this procedure(s) performed by any device by the staff at Skin Body Soul, including and not limited to, devices that are not FDA Approved, FDA approved devices or off-label applications of FDA Approved Devices as suggested by physician.
  10. By my signature below I also agree that in the event that there is any controversy, dispute or claim between Skin Body Soul, their representatives, or anyone affiliated with Skin Body Soul or myself arising from or involving my treatment or care at Skin Body Soul shall be resolved through binding arbitration, and shall be submitted to the American Arbitration Association for arbitration which shall be conducted in accordance with the association's arbitration rules in effect at the time of applying for arbitration. I understand the arbitral award is final and binding upon both parties, and that a demand for arbitration must be in writing and must be made by the aggrieved party within ninety (90) days of the event giving rise to the demand.