Terms & Conditions

TERMS AND CONDITIONS AND ARBITRATION AGREEMENT

This Agreement dated and effective the date above is made by and between My Goals Solutions, Inc., a New York medical management company (“Goals”), and the Patient identified above (the “Patient) (both the Patient and Goals may be referred to as a “Party” and together, as applicable, as the “Parties”).  

Release of Goals for Claims Related to Medical Care, Malpractice, Hiring or Vicarious Liability for the Medical Practices

                  Initially, the Patient understands and agrees that Goals is not a medical practice and is, rather, a management company that provides specific services for medical practices which do business under the trademarked tradename GOALS AESTHETICS AND PLASTIC SURGERY®.  As such, and subject to the terms and conditions below, which are applicable to the medical services, the Patient understands and agrees that it may not bring an action against Goals or any of its owners, managers, agents, employees or contractors, or their respective spouses related to any medical care and, especially for medical malpractice.  The Patient, by signing this agreement, waives any right to bring any such claim against Goals for medical malpractice, vicarious liability for the medical offices or surgeons, related to the hiring of the medical doctors, any rights under any state laws applicable to medical providers (except related to the handling of patient records which are handled and maintained by Goals as per its obligations to the medical offices, or any similar claims.  Patient further understands that neither Goals nor any of its agents or employees, including patient coordinators, are making representations about medical care, or whether a patient is eligible for surgery as those decisions are ultimately made by the surgeons.  Goals is provided with specific information from the medical providers to perform initial screening of patients.  Goals collects information for the surgeons and also serves in the administrative role of ensuring that all documentation is collected and proper in order for the surgeons to safely prepare for surgery upon the Patient.  This is a knowing waiver and release of these claims addressed above and, moreover, if the Patient, on their own or through counsel, brings an action against Goals related to these released claims, then the Patient understands that it, or its attorney, shall be individually and personally liable for all legal fees and costs to which Goals is forced to suffer to defend against same and seek dismissal.

List of Goals Aesthetics and Plastic Surgery® branded medical practices and the Surgeons at those locations:

As Goals is not a medical practice and provides administrative services for medical practices.  It does not perform medical care in any way.  Naming “Goals Plastic Surgery”, “Goals Aesthetics and Plastic Surgery”, or My Goals Solutions, Inc. in any filings in Court or Arbitration related to medical care, billing, collection, advertisement, or otherwise related to the care of the medical provider, the Patient agrees would be frivolous and in bad faith – unless it relates to the specific action of Goals and related to its direct conduct and not conduct performed on behalf of the medical practices.  As a result, the following is a list of the current medical practices in which Goals performs administrative services and all surgeons performing at those locations.  This may be subject to change and the Patient understands and agrees that it may be required to keep itself appraised of the current offices and surgeons.

State	Facility/Medical Practice	Surgeons with Privileges at Practice
New York	Brooklyn: Anthony R. Perkins, MD	Dr. Perkins
	Bronx: Anthony R. Perkins, MD	Dr. Perkins, Dr. Panda, Dr. Felstain
	100th St., Manhattan: Anthony R. Perkins, MD	Dr. Perkins
New Jersey	Perkins Medical Care NJ, P.C.	Dr. Perkins
Pennsylvania	Anthony R. Perkins, MD	Dr. Perkins, Dr. Panda
Maryland	Essential Surgical Management, LLC	Dr. Morrow
Georgia	Zemlyak Healthcare, P.C.	Dr. Zemlyak, Dr. Shannon
Texas	Keystone Center for Plastic & Reconstructive Surgery, LLC	Dr. Shannon

Arbitration Clause

This Agreement and any other documents referred to herein, and all Schedules hereto, shall be governed by, construed, and enforced in accordance with the laws of the State of New York, without regard to conflicts of laws principles except as set forth in this Agreement. Any disputes, whether related to the enforcement or interpretation of any clause or provision herein shall be adjudicated in binding arbitration pursuant to the terms herein which shall be construed and interpreted pursuant to the Federal Arbitration Act and not the laws of any state, and each party agrees and consents to same.

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AGREEMENT TO ARBITRATE ANY CLAIMS. READ THE FOLLOWING ARBITRATION PROVISION CAREFULLY, IT LIMITS YOUR RIGHTS, INCLUDING THE RIGHT TO MAINTAIN A COURT ACTION AND HAVE A JURY DECIDE YOUR RIGHTS AS TO ANY DISPUTE BETWEEN THE PARTIES AT ALL.  THIS IS A KNOWING WAIVER OF ANY CONSTITUTIONAL RIGHT TO APPEAR IN COURT

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The Parties agree to arbitrate any claim, dispute, or controversy, including all statutory claims and any state or federal claims, that may arise out, of or in any way relate to the relationship between Patient and Goals (or any of Goals’ managers, owners, principals, employees, agents or assigns, or its affiliated/branded medical practices and their respective doctors, employees, agents or assigns, affiliates, or others related thereto), including all state or federal laws or claims, this Agreement, and any of its addendums, schedules or associated documents, intellectual property rights or usage, medical malpractice, or otherwise; the intent being that all disputes between the parties, except as barred under the law or for emergent injunctive relief requiring immediate rulings, be brought in arbitration and not in a court of law.

BE ADVISED THAT this waiver of a court action and mandatory arbitration clause includes any claims for bodily injury or malpractice in any way AND any claims for malpractice in any way, whether against the surgeon, a medical practice, or Goals, must be brought in arbitration with the acknowledgment of the waiver and release of claims above related to medical care against Goals.  

BE ADVISED THAT you are also knowingly acknowledging and accepting that the Patient is waiving the right to have a Court determine whether their claims are arbitrable or any claims related to interpretation of this agreement, including whether or not the Patient agreed to same, shall be brought solely in arbitration.  

The exceptions to this obligation to arbitrate are those claims to which arbitration is specifically barred, such as for sexual harassment claims which may not be arbitrated, or, as referenced above, the need for injunctive relief. The Parties also agree to an exemption to arbitration to those claims which could be brought in Small Claims Court but the parties understand and agree that they are limiting such claims to those in the amount of Five Thousand Dollars ($5,000) and below, and, in such circumstances, the Parties agree that all such claims shall be brought solely in the Civil Court for the City of New York, located in New York County, to the explicit rejection of jurisdiction in any other venue with each Parties hereto consenting to both the personal and subject matter jurisdiction of such court to the exclusion of all other courts.  For clarity, any claims for monetary relief of $5,001 or greater, or seeking relief beyond simply $5,000 or less shall be arbitrated.

By agreeing to this Agreement, the Parties understand and agree that the each of them are waiving their rights to maintain other available resolution processes, such as a court action or administrate proceeding, to settle their disputes. The parties also agree to waive any right: (1) to pursue any claims arising under this agreement or related to any dispute between the Parties, including statutory, state or federal claims, as a class or collective action arbitration; or (2) to have any arbitration under this agreement consolidated with any other arbitration or proceeding. The Parties explicitly waive the right to a jury.

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By agreeing to this Agreement, the Parties also agree that any claims to be brought against Goals shall, to the extent that the applicable statute of limitations in New York is in excess of two years, to the reduced statute of limitations of two years.  The Parties agree that this is a contractual modification to statutes of limitation and have agreed to same.

The arbitration shall be conducted in accordance with the most updated version of the JAMS Comprehensive Arbitration Rules (the “Rules”) before a single arbitrator who shall be either a retired judge or an attorney. The Parties shall be subject to the filing fees as set forth in the Rules subject to reimbursement by the decision of the Arbitrator as legally permissible or pursuant to this Agreement. Each Party shall bear his or her or its own attorney, expert, or other fees and costs except as required by applicable law, and/or awarded by the Arbitrator under applicable law or this Agreement.

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The arbitration shall take place in New York, New York at a place either mutually agreed to by the Parties or as selected by the Arbitrator.

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The decision of the Arbitrator shall be binding upon all Parties.

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Any further relief sought by either Party will be subject to the decision of the Arbitrator except as to reduction of any award into a judgment which shall be brought in the State Courts located in New York County, New York to the explicit exclusion of any other jurisdiction.

If any part of this arbitration clause, other than waivers of class action rights, is found to be unenforceable for any reason, the remaining provisions shall remain enforceable.

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If a waiver of class/collective action and/or consolidation of rights is found unenforceable in any action in which class action remedies have been sought, this entire arbitration clause shall be deemed unenforceable, it being the intention and agreement of the parties not to arbitrate class/collective actions or in consolidated proceedings.

In the event that any subsequent agreement is entered into between the Parties, and such agreement contains a provision for arbitration of claims which conflicts with, or is inconsistent with this arbitration provision, the terms of such subsequent arbitration provision shall govern and control to the extent of such conflict or inconsistency other than any class/collective actions or consolidated actions in arbitration to which this arbitration clause shall control.

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Similarly, if any subsequent agreement is entered into between the Parties related to this Agreement that does not include an arbitration clause, the enforcement, alleged breach or interpretation of such agreement shall be adjudicated solely in arbitration as well, it being the parties’ intention that all issues and disputes between the parties hereto be handled solely in arbitration and not in a court of law or otherwise.

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If there are any questions as to whether or not the Parties have voluntarily agreed to enter into this Agreement, or were aware of this Arbitration clause, or any challenges are raised as to this Arbitration clause, its enforcement, agreement, consent, or interpretation are specifically delegated to the Arbitrator to determine and the Parties waive the right to have a Court determine same.

In the event that the Patient attempts to circumvent this arbitration requirement and otherwise seeks a court to interpret or determine the enforceability of this arbitration clause, then it shall pay to Goals all legal fees and costs incurred by Goals in compelling arbitration.  Indeed, in such an event, either the court or arbitrator shall award and compel the Patient, in addition to any other relief permissible, Goals’ reasonable counsel fees and costs associated with enforcement of such covenant as set forth herein.  The judge or arbitrator shall apply the Loadstar calculation and shall not reduce or diminish the amount of legal fees based upon either a proportionality or determination of percentage of success on the merits.  Rather, it shall look to the time reasonably and necessarily spent in total, notwithstanding the level of success, and award fees and costs as a result.

For clarity purposes, it is the specific intent of the Parties that they are waiving the right to seek any claim in a Court except to obtain immediate injunctive relief or as outlined herein for sexual harassment claims or for claims which could be brought in Small Claims Court.

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THIS ARBITRATION PROVISION LIMITS YOUR RIGHTS, INCLUDING YOUR RIGHT TO MAINTAIN A COURT ACTION OR HAVE A JURY. PLEASE READ IT CAREFULLY PRIOR TO SIGNING YOUR INVOICE AS, IF YOU SIGN YOUR INVOICE, YOU SHALL BE DEEMED TO HAVE READ, REVIEWED, AND AGREED TO THIS TERM IN FULL.

Limitation of Liability

GOALS IS NOT LIABLE FOR PATIENT’S TRAVELING EXPENSES UNDER ANY CIRCUMSTANCES. 

ADDITIONALLY, IN NO EVENT SHALL GOALS OR ANY BRANDED MEDICAL PRACTICE OR SURGEON BE LIABLE TO PATIENT OR ANY THIRD PARTY FOR ANY GENERAL, SPECIAL, INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES (INCLUDING, WITHOUT LIMITATION, INDIRECT, SPECIAL, PUNITIVE, OR EXEMPLARY DAMAGES FOR LOSS OF BUSINESS, LOSS OF PROFITS, OR BUSINESS INTERRUPTION) ARISING OUT OF OR CONNCTED IN ANY WAY WITH THIS AGREEMENT, PATIENT’S SERVICES, PATIENT’S INVOICE(S), PATIENT’S RELATIONSHIP WITH GOALS AND/OR ANY SERVICES RENDERED BY GOALS. THE TOTAL LIABILITY OF GOALS TO PATIENT FOR ALL DAMAGES, LOSSES AND CAUSES OF ACTION (WHETHER IN CONTRACT, TORT (INCLUDING BUT NOT LIMITED TO NEGLIGENCE), OR OTHERWISE) SHALL NOT EXCEED THE TOTAL FEES PAID BY PATIENT DURING THE TWELVE (12) MONTHS IMMEDIATELY PRECEDING THE EVENT GIVING RISE TO LIABILITY, EXCLUDING THE BOOKING FEE.  FURTHER, AND PER THE TERMS ABOVE, IN NO WAY MAY GOALS BE LIABLE FOR ANY CLAIMS FOR MEDICAL CARE OR MALPRACTICE AND PATIENT AGREES AND UNDERSTANDS THAT GOALS IS NOT A MEDICAL PROVIDER AND SHALL NOT BRING ANY CLAIMS AGAINST IT FOR PROFESSIONAL/MEDICAL MALPRACTICE.  NOTHING HEREIN SHALL BE DEEMED TO BAR ANY PATIENT FROM BRINGING SUCH ACTION FOR PROFESSIONAL/MEDICAL MALPRACTICE AGAINST ANY SURGEON THAT ACTUALLY PERFOMS SURGERY ON THE PATIENT AS LONG AS SAME IS CONSISTENT WITH THE TERMS HEREIN AND LIMITATIONS AS SET FORTH IN THESE TERMS AND CONDITIONS.

Patient Financial Responsibility: The Patient acknowledges and accepts that they are fully responsible for One Hundred Percent (100%) of the payment of all Services rendered, plus any additional charges incurred, in accordance with this Agreement. The Patient agrees to cover the entire cost of the Services, including any supplementary fees that may arise as stipulated in this Agreement, or as directed by the medical provider in their medical judgment.

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Booking Fee, Time Frame:  To schedule Services with Goals Aesthetics and Plastic Surgery® branded medical practice, the Patient is required to pay the Booking Fee specified on the patient’s Agreement. It is important to note that the Booking Fee is non-refundable (up to One Thousand Five Hundred Dollars ($1,500)) and shall be deemed earned upon payment. This fee encompasses and otherwise includes the following:

• Consultation & Treatment Planning: This is the Patient’s personalized surgical plan which is specifically tailored to the patient’s goals which is developed in conjunction with medical and non-medical staff along with the Patient. The value of same is identified on the first page of this Agreement and is, generally, at least $250.00.
• Facility Fee.  The scheduling of the procedure requires that the Facility schedule the patient and foregoes scheduling other patients at that time.  The facility fee for the surgical room is $750.00 for the surgery.  
• Facility Maintenance: Ensures a comfortable environment with advanced medical equipment.  This is $150.00 per surgery.
• Marketing & Development: Supports educational content, patient results, and practice growth.  This service is $100.00
• Consultant Expertise: Covers consultant salaries and ongoing training.  This is $100.00
• Operational & Care Costs: Includes administrative support, patient care, and compliance with medical safety standards.  This is $150.00

The Patient recognizes that the Total Price on the first page of this Agreement is calculated based on their weight at the time of executing the Agreement as this requires the calculation of what is medically safe to perform, the amount of anesthesia (local or otherwise required) and the staffing necessary for a same surgery. Unless advised by a medical professional the medical practice, or their representative/agent/assign, to gain weight prior to the procedure, if the patient gains more than five (5) pounds between the date on the Agreement and the scheduled date for any procedure, Goals retains the right, before or on the Procedure Date, to increase the price due to the Patient no longer being eligible for such price. In such an event, the Patient must pay an increase in price necessitated by the Patient’s increased weight.  Further, in the event that there is a promotional price, same is determined based upon eligibility for such price which typically has both time frame and weight/BMI restrictions. In the event that the Patient has increased their weight/BMI such that they are no longer eligible for such promotional price prior to having any surgery, the Patient will be required to pay the full amount indicated on the promotional ride for such procedure prior to any surgery being performed by a branded medical practice.  

After the Booking Fee is paid, the Patient has twelve (12) months from that date to complete all remaining payments, schedule, and undergo their surgery. If the surgery does not take place within this twelve (12) month period, the Booking Fee will be considered forfeited, and a new Booking Fee will be required to proceed. Additionally, any and all funds paid toward the procedure will be considered forfeited after the twelve (12) month period, without exception.

‍‍Beyond the initial twelve (12) months following the signing of the contract—during which only the Booking Fee is forfeited—the Patient will be subject to a Contract Expiration Fee of Five Hundred Dollars ($500) for each additional year that passes without the surgery being completed, refunded, or rescheduled.

Payment of Booking Fee. The Booking Fee must be paid in full at the time of the execution of this Agreement unless an extension to pay is granted in writing from a manager of Goals and at the sole and exclusive discretion of Goals. Failure to pay the Booking Fee in full will result in: (a) immediate cancellation of the procedure, (b) a $500 late fee, and, potentially, (c) referral to a collections agency and reporting to national credit bureaus.

Goals reserves the right, at its sole and exclusive discretion, to make exceptions to this policy. In such cases, funds may be transferred to a new contract, with applicable deductions. This policy also applies in instances where a refund has been approved by Goals.

Contract Modifications Leading to Extra Fees for the Patient.

The fee set forth above is calculated based upon several factors, provided by the Medical Providers and Medical Practices.  This incudes, but is not limited to, the surgeon’s fees, adjustments based upon location of the surgery, costs of anesthesia (local versus general or moderate sedation), promotions in place, BMI/weight issues, the type of surgery, etc.  As a result, any deviation or modification to the surgical plan may and likely will result in an increase of the surgical fee.  This includes the following:

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• Surgeon Change: The price for the surgery is, in part, calculated based upon the surgeon performing the procedure. Goals will do its best to comply with Patient requests for a specific surgeon that is privileged and otherwise experienced to perform surgeries at a specific Medical Practice but cannot guarantee that such surgeon will be available on the scheduled date for surgery.  Each surgeon has its own rate for the procedure and the charge to the patient is based upon this rate. However, if the Patient wishes to change the surgeon listed on the Agreement, after the execution of this Agreement, the Patient must pay the surgeon change fee of One Thousand Dollars ($1,000) for such change, but only if the rate for that surgeon is the same or less than the scheduled surgeon (the “Surgeon Change Fee”). If the Patient requests a change to surgeon that is has a higher rate than the scheduled surgeon, then, in addition to the Surgeon Change Fee, the Patient will be required to pay an additional cost difference between the prior surgeon and the newly selected surgeon, and such cost difference shall be provided to the Patient before any such change for written approval.  Any Surgeon Change Fee shall be paid to Goals prior to the surgery or else, unless they are unavailable to perform the surgery, the previously identified surgeon will perform the surgery. Notwithstanding the above, if the scheduled surgeon becomes unavailable, for any reason whatsoever, including leaving the practice, Goals shall, in good faith, attempt to reschedule the Patient with a different surgeon of equal cost for the same surgical date and without any additional cost to the Patient.  If, however, the Patient objects to such replacement surgeon, then the Patient understands and agrees that the surgical date may be delayed and rescheduled for a later date and waives any rights or claims for damages as a result of such change. Further, a change in the surgeon is not grounds to terminate, cancel, or alter this Agreement, or to seek or demand a refund, chargeback, or bring any financial claims against Goals.
• Change of Surgery Date: The Patient has the option to reschedule their surgery without incurring any penalties if they provide at least Sixty (60) days’ notice prior to the initially scheduled Surgery Date.  This is because Goals typically schedules patients for their surgeries at the Medical Practices three months in advance of the surgery date and changes in the date may impact other patients or the surgeons themselves. However, if the Patient reschedules their surgical procedure within 60 days of the original surgery date, the Patient understands and agrees that they shall be required to pay a Five Hundred Dollar ($500) rescheduling fee which must be paid prior to any rescheduled surgery (the “Rescheduling Fee”). Similarly, as it approaches the Surgery Date, rescheduling becomes more difficult as staff is scheduled, and equipment/disposables/ medicine and other aspects of the surgery are paid for and scheduled accordingly by the Medical Practice. Thus, rescheduling within fourteen (14) days from the Surgical Date is subject to a One Thousand Dollar ($1,000) rescheduling fee that must be paid prior to the Patient being rescheduled (the “Late Rescheduling Fee”).  Similarly, within seven (7) days prior to the Surgical Date is not possible absent an event of force majeure (and as discussed further below), and a cancelation fee will be applied at that time as discussed herein below. It is important to note that if a conflict or any other unforeseen circumstance arises on Goal’s end regarding the patient’s Surgery Date, Goals reserves the exclusive right to change the Surgery Date at no additional cost to the patient. Goals will make reasonable efforts to minimize any changes to the patient’s Surgery Date. Please be aware that any changes to the Surgery Date initiated by Goals shall not serve as a basis for the patient to cancel, reschedule, seek a refund, or seek a chargeback (see terms herein regarding waiver of rights to chargebacks) as to any of the Services.  Further, Goals may change the Surgery Date if the Patient has not made all payments due and owing to Goals for the Surgery within the time set forth to perform same.
• Location Change: After scheduling, a change in the location/medical practice performing the Surgery by the Patient will incur a One Thousand Dollar ($1,000) location change fee (“Location Change Fee”) which is due to the changed costs for different branded medical practices, rescheduling of staff, ordering of materials/disposables, etc. and the administrative costs of same. Goals may adjust the location due to conflicts without charging the Patient, and such changes do not allow for cancellation or rescheduling of Services as long as the new facility is within the same state as the prior (e.g. Goals will not reschedule a New York Patient to have their procedure in Georgia or similar without the expressed, written or recorded confirmation by the Patient to change same).
• Change of Services or Surgical Plan: If the Patient opts to alter their surgical plan, an additional fee of Five Hundred Dollars ($500) will apply if the change results in a less expensive procedure (a “Surgery Change Fee”). The surgical procedure may also be adjusted at the surgeon’s discretion on the day of surgery, potentially incurring additional costs, which is due to the surgeon’s medical judgment and is not the result of an action by Goals. In such an event, and if the cost will increase the cost for the procedure, then the Patient will be charged the retail price for any adjusted procedure as of the date of their initial Agreement and such payment must be made prior to the surgery occurring with such increase in price.
• Issues and Complications Leading to Extra Fees for the Patient: As discussed below, the practice of medicine, and especially plastic surgery, is not an exact science and each person reacts differently to the surgery, including results and the need for additional services during or after the procedure.  Further, this is an elective treatment, and the costs on the invoice are based upon information known at the time and general rules for patients absent deviations from the mean. Therefore, the Patient understands that certain complications or adjustments arising from surgery may lead to additional fees, including extra anesthesia, facility costs, and physician’s fees. The Patient is solely responsible for these costs and shall be invoiced for same subsequent to the Surgery.  Patient understands and agrees that it shall pay these increased costs upon request and without delay. It shall not be a basis to withhold payment, or demand a refund, or to challenge the fee, or to dispute such a fee, as to any additional costs due to lack of notice when such increased costs as identified herein are the result of additional services necessary and based upon medical judgment and/or providing of the safest and proper surgery for the Patient.

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Payment Options:

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• Direct Payments. Goals accepts cash (U.S. Dollars) and major credit cards (Visa, MasterCard, Discover, and American Express) for payments in accordance with payment for services under the terms of this Agreement. Personal, business, or cashier’s checks are NOT accepted.
• Payments Through Third-Party Lenders. Payments from financing companies must be made no earlier than 30 days and no later than 10 days before the surgery date. Third-party payments require government-issued ID and matching credit cards. Non-compliance will result in immediate cancellation of the Patient’s surgery and forfeiture of the Booking Fee.

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Forfeiture of Funds. If the Patient does not undergo the scheduled procedure within twelve (12) months of the Booking Fee payment, all payments made to Goals will be considered forfeited, and the company retains these funds without refund unless an extension is granted in writing.  This is because Goals and the Medical Practices rely upon this Agreement and the promises of the Patient in scheduling and any breach of the Agreement, including the failure to pay in full or appear for surgery, would cause irreparable harm to Goals and the amount of harm is difficult to calculate.  While some amounts are calculable (as described above), others are not calculable, because it includes complications with other patients and scheduling.  Therefore, as liquidated damages, the Parties hereto agree that this amount is reasonable in light of the damages that Goals will suffer as a result of delays and non-payment of the invoice in full.

‍Payment Deadline. If payment is made via methods described herein, Fifty Percent/One Half (50% or 1/2) of the Total Price must be paid at least thirty (30) days before the procedure and the full payment for Services and any fees must be received at least Fourteen (14) days before surgery. Unless an extension and waiver is provided by a manager of Goals in writing, any delays in payment will result in a rescheduling of the surgery and the increased surgical Rescheduling Fee shall be paid by Patient as a result.

No Disputes as to Payment with Financial Institution. By signing the invoice, Patient understands and agrees that it is not permitted and has waived the right to file any chargeback or dispute with any credit card company or financing institution and shall only seek a refund pursuant to the terms of this Agreement and no other methods including such self-help methods as chargebacks and challenges to the financial services entity including banks or credit card companies.  Patient understands that if Patient, or the card holder which has authorized a charge thereupon, disputes a valid charge(s) with a financial institution, credit card company, or financing company, as determined by the Goals’ records, then Goals reserves the right to remove Patient from all appointments and cancel all Services (in which case, Patient shall be deemed to have forfeited all payments made to Goals that have not been disputed). If Goals decides, in its sole and exclusive discretion, to continue providing services to Patient, then Patient shall be required to withdraw any and all dispute(s) and provide confirmation that Patient’s dispute of a valid charge has been withdrawn and fully resolved. If Patient does not provide proof that such dispute has been withdrawn and fully resolved, then Patient shall not be permitted to proceed unless and until the dispute has been fully resolved. However, the time frame of this Agreement, as stated above as to the surgical date above, shall not be tolled/extended during this time. If Goals receives notice that such dispute was resolved in its favor, then Patient shall be required to make all future payments in cash to ensure that no further disputes occur. If Goals receives notice that such dispute was not resolved in its favor, then Patient shall not be entitled to proceed unless the total amount of the Agreement(s) is paid by Patient in cash (including the disputed amount(s)) and Goals may take any and all action legally permitted to be reimbursed its damages as a result of this material breach of this Agreement. If Patient desires to proceed prior to the resolution of such dispute, and Goals, in its sole and exclusive discretion, allows Patient to proceed with the surgical process, then Patient shall be required to pay the total amount of the Agreement(s) (including the disputed amount(s)) in U.S. cash, and Patient shall not be entitled to any setoff based on the resolution of the dispute as the difference between the paid amount in cash and the credit card payment disputed an in favor of Goals shall be deemed as liquidated damages since the actual amount of damages is not calculable and Goals will be constrained to expend funds to address such dispute including, but not limited to, legal fees and costs. Further, if the Patient performs such challenge or dispute after the surgery, then the Patient understands and agrees that such shall be deemed fraud and they agree to same, and that, in addition to any compensatory damages that Goals suffers as a result of such conduct after the surgery, that the Patient will pay to Goals its reasonable legal fees and costs related to bringing any action to collect or to address/defend any charge backs. Patient further understands that if Patient has ever disputed a valid charge(s) with a financial institution, credit card company, or financing company, as determined by Goals’ records, for any monies paid to Goals, then Patient shall be required to pay in cash for all subsequent invoices and services with Goals (including the Booking Fee). Notwithstanding anything to the contrary above, in the event that the Patient files a chargeback and Goals is forced to enforce any part of this agreement, including, but not limited to, seeking an action in a court or arbitration pursuant to this Agreement in order to obtain payment for services provided, then, in addition to the amount to be paid by the Patient, Patient shall also pay to Goals, and the Court or Arbitrator shall award, Goals’ legal fees and costs for enforcement and collection of outstanding amounts. In determination of the legal fee to be awarded, the Court or Arbitrator shall apply the standards as set forth in this Agreement as to compelling arbitration.

Collections & Credit Reporting. Any delinquent account, including but not limited to non-payment, chargebacks, or violation of payment terms, will be referred to a third-party collections agency. Such accounts may also be reported to national credit bureaus and may result in a legal action for recovery of outstanding balances. Patient expressly acknowledges and accepts these consequences.

Required Government Issued Identification. When identification is required of Patient by Goals, the Patient must provide one form of a government issued identification which contains a picture and SHALL NOT BE EXPIRED. The forms of identification acceptable to Goals include: (1) State issued Driver’s License; (2) State issued Non-Driver-ID; (3) Government-issued passport; (4) Military identification; or (5) Government-issued Green Card/Resident Alien Card.  The name on the Governmental ID shall be the same as on any credit card used to pay for services unless such is being paid by a third-party and, in such circumstance, such third-party paying for the services shall provide a copy of their Governmental ID and have a matching name thereupon as any credit card being used.  This is to avoid fraud.  If the credit card and the Governmental ID do not match, then such may not be used.  Further, if a Patient’s surgery is being paid for by a third-party, then that person must personally show their identification at the same time as the payment and sign such forms as Goals deems reasonably necessary to ensure payments.

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Pre-Surgical Laboratory Testing & Medical Clearances. Patient is required to have all laboratory results and medical clearance results submitted to Goals within forty-five to sixty (45 to 60) days prior to Patient’s scheduled Surgery Date. If Patient’s surgery was scheduled less than sixty (60) days but greater than forty-five (45) days from the scheduled surgery date, then Patient understands that the laboratory results and medical clearances must be expedited and submitted to Goals within fourteen (14) days. If Patient’s surgery was scheduled less than forty-five (45) days but greater than thirty (30) days from the scheduled Surgery Date, then Patient understands that the laboratory results and medical clearances must be expedited and submitted to Goals within seven (7) days.  If Patient’s surgery was scheduled less than thirty (30) days from the scheduled Surgery Date, then Patient understands that the laboratory results and medical clearances must be expedited and submitted to Goals by no later than seventy-two (72) hours prior to Patient’s scheduled Surgery Date. Goals, as determined by one of the surgeons at one of the branded medical practices, reserves the right to request additional laboratory testing, additional medical clearances, or any other studies to ensure that Patient is fully cleared as a candidate for surgery. Any additional testing, clearances, or studies requested by the surgeon shall be submitted to Goals no later than the date specified to Patient by Goals (such as the labs department). Due dates are subject to change by Goals. Subject to the exceptions set forth in below. failure to provide the requested laboratory results, clearances, or studies by the stated deadlines will result in the cancellation of Patient’s surgery without any refund of the Booking Fee. Patient is solely responsible for obtaining and paying for Patient’s medical clearances, laboratory testing, and any other studies, tests, or results requested by Goals and/or the surgeon.

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Pre-Surgical Requirements; Surgery Cancellation Circumstances; Extra Fees

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• BMI Requirements: For surgeries that include a Tummy Tuck/Abdominoplasty and FlexSculpt® 360, it is mandatory for the Patient to have a Body Mass Index (“BMI”) of 31 or lower on the day of their pre-operative appointment. For surgeries that do not include a Tummy Tuck/Abdominoplasty, the patient must have a BMI of 60 or lower on the day of pre-operative appointment. At and subject to the surgeon’s medical discretion, the surgeon may elect to make exceptions to this baseline requirement. If Patient does not call and reschedule Patient’s surgery within 48 hours, which surgery shall take place within the 12-month window provided above, then Patient shall be refunded all monies paid with the exception of the Non-Refundable Booking Fee and a $2,500 cancellation fee. If Patient calls and reschedules Patient’s surgery within 48 hours, which surgery date is within the 12-month window provided above, then Patient shall not be subject to the cancellation fee so long as all monies paid by Patient (or on behalf of Patient) to Goals remain with Goals and are not disputed by Patient or their benefactor. If the 12-month window provided above has elapsed, then Patient must be issued a new Agreement, including a new Booking Fee, to reschedule any services at the then-current rate, and any monies previously paid to Goals (not including the Booking Fee) shall be applied towards the new Agreement.
• Pregnancy Prior to Surgery. If the Patient is pregnant or becomes pregnant between the invoice date and the Surgical Date, surgery cannot proceed. If the Patient experiences a pregnancy termination within six months of the Surgery Date then the procedure may proceed six months thereafter. A pregnancy test will be conducted on the day of surgery, and if positive, the surgery will be cancelled, incurring a $2,500 cancellation fee, unless the Patient opts for rescheduling. In the event a Patient becomes pregnant and subsequently chooses to proceed with surgery after childbirth, the surgical price may be subject to change at the sole discretion of GOALS. Pricing and promotional offers will only be discussed once the Patient contacts GOALS to reschedule and submits a valid copy of the child’s birth certificate. Any adjustments to the price or promotional offer will be based on the current pricing and promotions available at the time of rescheduling.[JML1] 
• Hemoglobin: Any Patient with a hemoglobin level of less than 11.0 as determined by the laboratory results submitted to Goals within the time frame required by Goals will be cancelled and may be rescheduled by Patient within the time frame provided herein, which may be subject to additional fees. However, a Patient whose Services only include a Breast Augmentation may have a hemoglobin level of less than 11.0. Patient must not have an A1C level higher than 6.9 as determined by the laboratory results submitted to Goals within the time frame required by Goals, otherwise Patient’s surgery will be cancelled and may be rescheduled by Patient within the time frame provided by Section 4 of this Agreement, which may be subject to additional fees.
• Medications for Pre-Existing Conditions. If Patient has been diagnosed with a pre-existing medical condition that can be regulated or controlled, Patient must seek additional treatment from Patient’s primary doctor or specialist to control the condition, which may include taking prescribed medications, before scheduling or rescheduling Patient’s Services.
• Drug Test(s): Patient understands and agrees that certain controlled substances can have a substantial impact on the ability of the patient to heal, or to be able to proceed in the surgery without complications.  This includes, but is not limited to, cocaine, non-prescribed (and disclosed) opiates, psychedelics (including cannabis/THC/marijuana) and other many other medicines.  Patient agrees to disclose any and all controlled substances and other medications used by the Patient. Patient further agrees to have a drug test administered by the Medical Practice on the day of surgery prior to the start of the surgery. In the event the drug test is positive, depending on the substance as identified, Patient’s surgery will be immediately cancelled, and all monies paid to Goals shall be deemed forfeited without any refund to Patient as same shall be deemed a material breach of this Agreement. However, if Patient decides to reschedule the Services, then Patient shall be required to pay an additional One Thousand Five Hundred Dollars ($1,500.00) rescheduling fee, and the monies previously paid to Goals will be applied toward the Services.
• Nicotine Test. Patient understands that the use of nicotine of any form (smoking tobacco or vaporized nicotine) may have a substantial impact on the Patient’s ability to heal or proceed with the procedure. Patient has disclosed any use of nicotine and agrees to cease using same for a period of no less than sixty (60) days prior to and subsequent to the Surgical Date.  Prior to surgery, a nicotine test will also be administered. A positive result will result in cancellation and forfeiture of all payments. If the Patient chooses to reschedule, a One Thousand Five Hundred Dollars ($1500) rescheduling fee will apply. If any complications arise subsequent to the surgery and it is discovered that Patient used such nicotine product during that time, Patient agrees that it shall be deemed to have waived any rights as the use of nicotine in this period shall be deemed a material breach of this Agreement.
• Misrepresentation of Medical Information. Patient understands that the formation of the surgical plan, and determination of costs for the surgery/services, is based upon the information that Patient provides to Goals and/or the Medical Practices and its surgeons. Patient understands that any falsification or misrepresentation of medical records, medical history, or any other relevant facts related to the medical condition of the Patient will result in forfeiture of all payments, and the Patient will be barred from receiving any services as such shall be deemed a material breach of this Agreement.

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Appointments & Pre-operative Visits: Patient will receive the time of surgery the day before surgery. Unless otherwise instructed by Goals, Patient must be physically present in Goals’ office for the pre-operative visit the day before the surgery for the completion of pre-operative paperwork, to receive any prescriptions, check mandatory necessities and to make a final payment in full for any amount outstanding. Patient understands that Patient’s surgical plan consists of a recommendation based on information and photographs provided by Patient and as per the guidelines provided by the medical practices and the surgeons and not that of Goals, and that, at the time of Patient’s exam in the office, it may be necessary to modify Patient’s surgical plan, which may involve additional costs. Subject to the exceptions set forth in this Agreement, Patient’s failure to appear for the pre-operative visit will result in the immediate cancellation of Patient’s surgery and all monies paid to Goals shall be deemed forfeited without any refund to Patient as liquidated damages consistent with the terms herein. However, if Patient decides to reschedule the sergury, then Patient shall be required to pay an additional Two Thousand Five Hundred Dollars ($2,500) cancellation fee, and the monies previously paid to Goals will be applied toward the new date for the surgery. Additionally, Patient understands and agrees that the recommended procedure may be changed the day of surgery, subject to the surgeon’s discretion, which may result in additional costs to Patient – this is typically based upon further review and testing by the surgeon, conference with the surgeon regarding the surgical plan, changes in weight or BMI or other decisions for medical necessity. Further, subject to the exceptions set forth in this Agreement, if Patient fails to appear for the surgical procedure on the scheduled surgery date, all monies paid to Goals shall be deemed forfeited as liquidated damages without any refund to Patient. However, if Patient decides to reschedule the Services, then Patient shall be required to pay an additional Two Thousand Five Hundred Dollars ($2,500) cancellation fee, and the monies previously paid to Goals will be applied toward the Services. Goals seeks to make the process as easy as possible without any compromise to Patient’s health or safety. Patient understands that it is entitled to meet with the surgeon prior to the Surgery Date, either in person or virtually. Patient understands and agrees that it shall contact Goals to schedule such appointment in advance.  Patient is entitled to a single pre-operative visit with the surgeon prior to the Surgical Date which is included in the cost of the surgery should the Patient desire this medical appointment with the surgeon.  Any further medical appointment with the surgeon shall be subject to a medical appointment fee of Two Hundred Fifty Dollars ($250.00) which shall be paid the Patient prior to the appointment.  

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Post-operative Visits: Goals, by way of the guidance provided by the Medical Practices and the surgeons, has been directed to recommend that Patients attend the following post-operative appointments after any procedure, with the surgeon who performed the Services, at the designated location. This will typically happen within three (3) months after the procedure date. Goals arranges for the post-operative visits with the surgeon at no additional cost. For any additional pre-operative or postoperative visits with the surgeon, patients will be charged a fee of $250 per visit. It is recommended that the patient schedule a pre-operative appointment with a surgeon, but it is not mandatory.  However, in the event of a medical complication, patients may attend additional follow-up visits with the surgeon, free of charge, subject to the surgeon’s medical discretion and direction.

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Caretaker Policy. Patient understands that Patient is responsible for ensuring that a caretaker of legal age (18 years or older) shall pick up the Patient after Patient’s surgical procedure. The name and information of the individual caretaker shall be provided by Patient to Goals prior to surgery. UNDER NO CIRCUMSTANCES SHALL A RIDE SHARE OR TAXI QUALIFY AS A CARETAKER. Patient understands that the effects of anesthesia and surgery make it necessary to have a proper caretaker and that this policy is mandatory to ensure Patient’s safety. This is mandatory and a directive from the medical providers.

Goals and/or the Medical Practices will inform Patient’s caretaker when the surgery has ended, and the caretaker must pick Patient up no longer than one hour after being notified that the Patient is ready to be discharged. IF THE PATIENT’S CARETAKER FAILS TO PROMPTLY PICK UP THE PATIENT WITHIN THE ONE-HOUR WINDOW AFTER BEING NOTIFIED THAT THE PATIENT IS READY TO BE DISCHARGED, THEN A FEE OF TWO HUNDRED FIFTY DOLLARS ($250) WILL BE CHARGED FOR EVERY 15 MINUTES OF DELAY AS LIQUIDATED DAMAGES TO COMPENSATE FOR THE POST-SURGICAL ROOMS BEING UTILIZED, STAFF COSTS, AND OTHER EXPENSES WHICH ARE NECESSITATED BY THE DELAY.

If the caretaker does not arrive within a reasonable time, Goals reserves the right to call an ambulance or emergency medical services for patient transportation, and the Patient shall be responsible for all associated costs with such transfer.

Recovery Period: Patients must remain within 20 miles of the surgery location for at least five days for post-operative care. Failure to comply is considered leaving against medical advice as this is a mandatory requirement from the medical providers. Patient may sign a waiver of this obligation, however, if the Patient leaves this designated zone within the five day post-operative period, or waive the right to post-operative care, Patient waives all rights to any post-operative care, and further (unless confined to a medical facility requiring being out of the 20-mile zone) it is agreed that the Patient has voluntarily waives any rights to bring an action against Goals, the medical provider, or the surgeon for any type of relief as well as bring any claims against the surgeon or any medical staff arising out of or related to claims of medical malpractice as a result of it being construed, and Patient agreeing to same, that Patient has failed to comply with medical directions and care instructions.  Indeed, if Patient fails to comply with this provision and later brings an action against Goals, any medical practice so branded, or any surgeon, alleging medical malpractice, Patient agrees that same shall be dismissed, with prejudice, for Patient’s decision to leave the zone identified herein and as a result of Patient’s knowing waiver or rights and decision to avoid such care.

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Additional Non-Surgical Services. Post-surgical or lymphatic massages may be offered to patients as an option for faster recovery after the surgery. It is important to note that these massages are specifically designed for post-operative purposes and will only last for a duration of 30 minutes. Please be aware that all messages purchased are non-refundable.

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Surgical Accessories. These are non-refundable and non-transferable.

Additional Fees Imposed on the Patient. Any extra fees, including rescheduling, cancellation, surgeon, and change fees, do not apply toward Service costs and shall be paid to Goals as per the terms herein.

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Touch-Up Policy:  Cosmetic surgeries aim to enhance areas of concern with a high success rate, but outcomes depend on various uncontrollable factors. The Medical Provider/Surgeon may offer touch-up procedures within one year of the initial surgery at the surgeon’s discretion, subject to costs outlined herein. However, the following conditions must be met:

• The patient’s weight has remained the same since the Surgical Date, with no more than a 2% deviation in BMI.
• The Patient is not, and has not been, pregnant or given birth since the Surgical Date.
• The Patient has not smoked or used any tobacco or nicotine products since the Surgical Date.
• The Patient has followed all the post-operative care instructions in the “Patient Information Booklet” including, but not limited to,
  • Wearing all required compression garments for the prescribed duration
  • Received at least ten (10) post-operative massages from Goals or from a branded medical practice.
  • Attended all required post-operative follow-up appointments and responded to all post-operative messages.
  • Followed all other post-operative instructions in the “Patient Information Booklet” as well as all post-operative care directed to the Patient from the surgeon.
  • The touch-up is not a request for additional fat removal/liposuction, or fat injections, in an area not treated with autologous fat transfer in the original procedure.
  • The touch-up is specifically for the problem area that was treated in the original procedure.  It is important to note that revisions/touch-ups may be considered new procedures and are sometimes intended solely to correct minor issues that naturally arise from the initial procedure, such as concave areas or small bulges.
  • The touch-up is not applicable for patients who receive any form of post-operative care or services, including massages or otherwise, except for emergency care, from a third-party, or for a Patient who has signed a written waiver of post-operative care.

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Fees & Costs: If the touch-up procedure by the surgeon that performed Patient’s initial procedure requires Patient to be placed under general anesthesia, as determined by the sole and exclusive discretion of the surgeon, then Patient shall be required to pay an operating fee between Two Thousand Five Hundred Dollars and Three Thousand Five Hundred Dollars ($2,500-$3,500), which includes the costs for the operating room and general anesthesia including the anesthesiologist or CNA. If the touch-up procedure by the surgeon that performed Patient’s initial procedure does not require Patient to be placed under general anesthesia, but can instead be performed under local anesthesia, as determined by the sole and exclusive medical discretion of the surgeon, then: Patient shall be required to pay an operating fee between One Thousand Five Hundred Dollars and two Thousand Dollars ($1,500-$2,000), which includes the costs for the operating room and local anesthesia as well as all necessary medical staffing.

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Exclusions and Additional Costs. Touch-ups do not cover services not included in the original procedure or materials used. Additional testing or fees may also apply. A new agreement may also be required.

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Medical Records. If Patient requests medical records, Patient shall be responsible for paying all such associated fees as set forth in the law of the state in which the surgery was performed.  This fee must be paid in advance of production of the medical records and shall be conveyed to the Patient before medical records are released.  Further, and to avoid confusion, only certain photographs taken may be considered “medical records.”  Before and after photographs taken by Goals for purposes other than for medical treatment (such as for advertising, portfolio, or other reasons) and not to track progress or healing post-surgery, are not part of the medical record and shall not be produced under any circumstance.  Further, the Patient understands and agrees that any such photographs, including those used for diagnostic or care purposes are the sole and exclusive property of Goals and are protected under the Copyright Act of the United States, as amended, and may not be used by the Patient for any purpose other than for a personal record of same or for other legal purposes.  Same may not be posted on social media or elsewhere without the explicit written permission of an agent of Goals with actual authority to permit such use.

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Cancellation & Refund Policy; Exceptions:

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• General Terms: Goals understands that situations may arise that could force a Patient to postpone their scheduled services. However, Patients must understand that such changes affect the surgeon, operating room staff, facility schedules, and other patients. The surgeon’s and staff’s time is valuable, and Goals, as a result, mandates that Patients exercise courtesy and consideration when managing their appointments. However, as to unforeseen circumstances, please contact Goals to discuss same and it will be within Goals’ sole and exclusive discretion, as in writing from a manager, to permit any modification to the terms herein. Be guided that abusive, aggressive, threatening, or accusatory statements to Goals or its agents will result in a rejection of any courtesies.  Further, a lack of sufficient funds is not grounds to issue a refund.
• Cancellation and Refund Policies: The following are the cancellation and refund policies of Goals, which are governed by the terms and conditions of this Agreement:
  • As set forth above, the Booking Fee is non-refundable under any circumstances or for any reason and same is non-negotiable as it is for services already rendered upon booking.
  • If the surgeon or CRNA/anesthesiologist cancels the surgery on the surgical day due to a medical condition that disqualifies the Patient from proceeding, the Patient must pay a Two Thousand Five Hundred Dollars ($2,500) facility and professional services fee in addition to the non-refundable Booking Fee which will not be refunded for any reason as such costs have already been expended by Goals for such surgery.
  • If the surgery is canceled on the surgical day as a result of the Patient’s withholding of medical information or failure to adhere to pre-operative instructions (as determined by the Medical Provider and/or Surgeon, and as set forth either herein or in the materials provided to the Patient), the Patient must pay a Two Thousand Five Hundred Dollar ($2,500) Cancellation Fee in addition to the non-refundable Booking Fee.
  • Failure to submit requested and/or required laboratory results, clearances, or studies by stated deadlines, leading to cancellation or rescheduling of the surgery, will result in a One Thousand Five Hundred Dollar ($1,500) Cancellation/Rescheduling fee in addition to the non-refundable Booking Fee.
  • Failure to appear for the surgical procedure on the scheduled Surgical Date, unless the result of an event of force majeure or as a result of Patient being confined to a medical facility, will result in a Two Thousand Five Hundred Dollar ($2,500) Cancellation Fee in addition to the non-refundable Booking Fee.
  • Cancellation by the Patient within 48 hours of the scheduled surgery date, or on the day of surgery, will result in a Two Thousand Five Hundred Dollar ($2,500) Cancellation Fee in addition to the non-refundable Booking Fee.
  • Failure to attend a scheduled pre-operative visit will result in a Two Thousand Five Hundred Dollar ($2,500) Cancellation Fee in addition to the non-refundable Booking Fee.
  • If the surgeon or CRNA/anesthesiologist determines on the day of the procedure that the surgery cannot or should not proceed for a non-medical necessity reason (such as due to violent or inappropriate behavior of the Patient), or if the Patient declines the surgery as determined appropriate by the surgeon, the Patient must pay a Two Thousand Five Hundred Dollar ($2,500) Facility and Medical Staffing Fee in addition to the non-refundable Booking Fee.
  • If the Patient has paid for a massage but does not receive it due to Goals’ inability to schedule or reschedule the massage, the Patient willbe entitled to a refund for the amount paid for such massage(s).
  • If the Patient paid for a specific surgical procedure but did not receive it due to the surgeon’s medical discretion (e.g., paying for liposuction of the abdomen and arms but only receiving liposuction of the abdomen), the Patient will be entitled to a refund for only the amount corresponding to the part of the procedure not performed.

Nothing herein shall be deemed to obligate Goals or the surgeon or medical provider to either charge or waive any such fee above and such fees may be waived on the sole and exclusive discretion of Goals and as a result of circumstances as they exist at the time.

Further, and notwithstanding anything to the contrary, if a patient is unable or unwilling to proceed with the scheduled surgery due to a recent death (within the seven (7) days preceding the surgical date) of an immediate family member (spouse, parent, sibling, or child), then there shall be no additional fees charged and the surgery may be rescheduled within the year period from the payment as set forth above, but the Patient must provide a certified copy of a death certificate evidencing same. Failure to provide same may result in the imposition of additional fees as set forth above or require the Patient to forfeit any payments made towards the surgery as per the terms herein.

‍Refund Requests and Cancellation Fees:

If a Patient requests a refund after signing the surgical agreement, a Cancellation Fee will be applied based on the type of anesthesia selected. The applicable fees are as follows:

• $2,500 for procedures scheduled under Local Anesthesia
• $3,500 for procedures scheduled under General Anesthesia

These fees will be deducted from any refundable amount due to the Patient.

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Refund Processing Time: Refunds, when applicable and approved (at the sole and exclusive discretion of Goals), may take forty-five (45) business days or more to process and issue payment.  Patient understands that Goals may require that Patient sign a release in order to make payment of a refund that is not being provided as a result of medical necessity. Patient further understands that if it makes a claim for funds pursuant to a refund agreement prior to payment of same, which could be delayed, then same will be dismissed and, in the event Goals is forced to retain legal counsel to defend against same, then the Patient agrees that it will pay all of Goals legal fees and costs addressing same and per the terms herein.

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Cancellations, No-Shows, and Unauthorized Departures: In the event that the Patient fails to appear for a scheduled procedure, or, having checked in, elects to depart the facility without the prior written or documented medical authorization of a duly licensed provider, such conduct shall constitute a voluntary cancellation by the Patient.

By executing this Agreement, the Patient expressly acknowledges and agrees that any such voluntary cancellation shall result in the immediate and irrevocable forfeiture of all fees, deposits, and monies previously paid to the Practice, without exception as liquidated damages. The Patient further acknowledges and agrees that under no circumstances shall such monies be refundable, applicable as credit, or transferable toward any future services, procedures, or rescheduling.

For avoidance of doubt, the Patient shall have no legal, contractual, or equitable claim to reimbursement or compensation in connection with such voluntary cancellation, and the Practice shall bear no liability whatsoever arising therefrom.

Your departure without medical authorization, as set forth herein, constituted a voluntary cancellation under these Terms and Conditions.

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No Warranties. PATIENT RECOGNIZES THAT THE PRACTICE OF MEDICINE AND SURGERY IS NOT AN EXACT SCIENCE AND UNDERSTANDS AND ACCEPTS THAT FEES ARE PAID FOR PERFORMANCE OF THE SERVICES ONLY, AND NOT A GUARANTEED RESULT. PATIENT ACKNOWLEDGES THAT ALTHOUGH A GOOD OUTCOME IS EXPECTED, AND A REASONABLE EFFORT HAS BEEN MADE TO ESTABLISH REALISTIC EXPECTATIONS, NEITHER GOALS, ANY MEDICAL PRACTICE IDENTIFIED HEREIN, OR ANY SURGEON RETAINED TO PERFORM ANY SURGERY AS A RESULT OF THIS AGREEMENT, DOES OR MAY PROVIDE ANY TYPE WARRANTY, EXPRESSED OR IMPLIED, AS TO THE RESULTS THAT MAY BE OBTAINED.  PATIENT DISSATISFACTION WITH THE ULTIMATE RESULTS IS UNDERSTOOD BY THE PATIENT TO BE DUE TO SEVERAL FACTORS AND IS NOT A BASIS FOR ALLEGING BREACH, FRAUD, OR MALPRACTICE OF ANY KIND.

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Disclaimer of Liability for Third-Party Products & Services. AS PART OF ITS SERVICES TO PATIENT, COMPANY MAY OFFER THIRD PARTY PRODUCTS AND SERVICES. COMPANY DISCLAIMS ANY AND ALL LIABILITY, INCLUDING ANY EXPRESS OR IMPLIED WARRANTIES, WHETHER ORAL OR WRITTEN, FOR SUCH THIRD-PARTY PRODUCTS AND SERVICES. PATIENT ACKNOWLEDGES THAT NO REPRESENTATION HAS BEEN MADE BY GOALS, THE MEDICAL PRACTICES OR SURGEONS AS TO THE FITNESS OF THE THIRD-PARTY PRODUCTS OR SERVICES FOR PATIENT’S INTENDED PURPOSE. PATIENT AGREES TO HOLD GOALS, THE MEDICAL PRACTICES AND/OR SURGEONS AND ALL OF THEIR RESPECTIVE EMPLOYEES, OWNERS, DOCTORS, DIRECTORS, OFFICERS AND AFFILIATES HARMLESS FROM ANY DAMAGES, LOSSES, CLAIMS, OBLIGATIONS, LIABILITIES, COSTS, AND EXPENSES ARISING FROM ANY THIRD-PARTY PRODUCTS OR SERVICES