Pre-operative - Farjo Hair Institute

Patient Consent
PAYMENT OF FEES POLICY
continued...
Photography
I also hereby authorise the medical team to take photographs of me
before, during and after treatment. I give this consent on condition that
the said photographs are not used for any promotional purposes without
my approval.
Report
We would like to send a report to your GP or referral doctor of your
treatment. If you decline consent, then a report will be sent to you so that
you may pass it to your doctor if the need arises.
1. A deposit of £2000 (set-up fee) is required upon making your surgery appointment. This must
be received within 10 days of our written confirmation; otherwise your appointment cannot be
guaranteed.
2. The balance of your surgery fee must be settled at the latest on the day of surgery BEFORE the
actual operation.
3. You can pay the balance by any of the following methods:
a. Cash
b. Building society cheque
c. Bank draft
d. All major credit and charge cards (subject to 1.5% admin charge, 3.5% if AMEX)
e. All major debit cards including Maestro/Switch (preferred method)
f. Personal and credit card cheques can only be accepted if received at our Manchester premises
at least 10 working days before your appointment.
4. Refunds:
a. Any fees paid are fully refundable if you cancel or change
your surgery no less than 2 weeks prior to your appointment.
b. If you cancel or change your surgery within 2 weeks of
your appointment, we will charge or retain £1000.
c. If you cancel or change your surgery within 1 week of your
appointment we will charge or retain £2000.
d. If you cancel or change your surgery within 2 days of your
appointment we will charge or retain the full value of the
surgery as invoiced.
If you require any help regarding payment please contact us
as soon as possible.
All correspondence to:
Farjo Medical Centre
Arthur House, Chorlton Street,
Manchester M1 3FH
Tel: 08453 132 131 International: (+44) 161 237 3517
Email: [email protected] www.farjo.com
Fax: 0161 237 3279
Hair Restoration Surgery & Medicine Since 1992
Pre-operative
Instructions Booklet