Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.This agreement is a Deposit Payment Agreement between the patient and SkinRenew. You, the patient, authorize SkinRenew Laser Medical Center & Cosmetic Surgery to charge your credit card. We accept all major credit cards. This Deposit Payment Agreement is for a: Consultation or Treatment at SkinRenew If the appointment gets missed, the deposit is non-refundable - if not canceled within two business days. SKINRENEW APPOINTMENT - NO SHOW POLICY: When we reserve time for our clients, we want you to feel cared for. That's why we care about finding a time that will work for both of us. We place immense value in your time and hope you will honor us with the same in turn. SkinRenew is always busy, so prior appointments are highly recommended; walk-ins or last-minute appointments are welcome when time permits. Please call and ask if we have any cancellations, and we will do our best to get you an appointment if possible. Due to the medical nature of many of our treatments, appointments can sometimes exceed their scheduled time. Therefore, please be patient and know that you will receive the same exceptional service and personal attention from us. CANCELLATION: SkinRenew requires TWO BUSINESS DAYS in advance if you cannot make your appointment. In addition, we make courtesy text messages reminding you of your appointment; however, these are only courtesy messages, and we ask that you assume responsibility for remembering your appointment date and time. SCHEDULING DEPOSIT: SkinRenew has a scheduling deposit for Consults, Dermal Fillers, Micro-Needling, Lasers, Thread Lifting, and all Aesthetician appointments. A deposit is required when booking these appointments. This deposit guarantees your reservation. The deposit applies to procedure costs or any service within 30 days if the appointment is kept. If the appointment is missed, the deposit is non-refundable - if not canceled within two business days. Scheduling deposit for Dr. Kwon $75 Scheduling deposit for our Aesthetician $25 PRIVATE POLICY: At SkinRenew Laser Medical Center & Cosmetic Surgery, we take your choice to use our clinic and services seriously and appreciate your trust in our clinic. In addition, we respect your privacy and are committed to protecting the security of your personal information. DateName *FirstLastPatient Signature *Submit