Treatment Authorization and Insurance Waiver

I authorize AW Medspa to treat me. I have been informed that AW Medspa does not accept any form of health insurance. This includes Medicare, Medicaid, Workers Comp, or any type of private insurance. I understand that I am financially responsible for services rendered to me at the time of service. This waiver serves as my decision to waive usage of my medical insurance. A photocopy of this authorization shall be considered as effective and valid as the original.

Cancellation / No Show Policy Waiver

I understand that when I schedule an appointment, AW Medspa is allocating that time to specifically focus on me. I understand that I must be on time for my appointment and that if I am late, AW Medspa has the authority to either shorten my appointment time or cancel and reschedule my appointment. 

I understand that when scheduling for injectable or microneedling appointments that a credit or debit card must be put on file due to AW Medspa’s cancellation policy. AW Medspa understands that there may be unforeseen circumstances that can cause last minute cancellations but it is my job to notify AW Medspa within 48 hours of my appointment time via phone, text, or email if I need to cancel. Failure to cancel within the cancellation notice will result in your downpayment covering your cancelation fee rather than going towards your appointment. AW Medspa also has the right to redeem external certificates if a client does not show or repeatedly reschedules the appointment within the cancellation notice.

I understand that AW Medspa has the right to request a valid credit card to be put on file for future appointments and charge the appropriate fees to cover no show fees and/or last minute cancellations.