Visage Cosmetic Clinic Surgical Cancellation & Rescheduling Policy

When scheduling a surgical procedure with Visage, we must reserve time in our operating room. This requires us to secure Dr. Esmail’s schedule and operating room time, involving surgical nurses, technicians, and anesthesiologists to be available. Furthermore, we must turn down any other patient who wants surgery on the day and the time we have reserved on your behalf.

When scheduling a surgical procedure which includes Hair Transplants, please see below the schedule of payments and policies surrounding cancellation of procedure. The surgical payment agreement is outlined below. When you feel you understand the contents of this form, and agree with its terms, please sign and date on the line indicated below.

I understand that:

Surgical Deposit

Once my surgical procedure is scheduled with Visage, and the operating room / procedural room is reserved for me, it is no longer available to other patients. Therefore, I agree to submit a deposit of $1,000.00 (variable, depending on dates/procedure) at the time I request my surgery to be scheduled. NOTE: If the procedure is $2,500.00 or less, one half of the surgical fee is required.

The surgical deposit is refundable up to 30 days prior to the procedure. The deposit is then non-refundable less than 30 days prior to the procedure and will be put towards the final payment.

Balance Owing

All surgical fees must be paid in full no less than four weeks prior to the date of the procedure.
Balance of the procedure is non-refundable at this time.

Cancellation and Rescheduling Policy:

Note: If a revision under IV sedation is required, an Anesthetic fee of $1,000.00 +GST will apply

There will be no funds held back in the event of a documentable medical reason with a treating doctor’s statement.