Please complete this form as accuratley as possible. All fields marked with an * are mandatory and the
surgeon will not be able to assess you for surgery without them completed.
NOTE: It is mandatory for all patients to travel with a carer. Clients who travel interstate without a carer are likely to be
refused surgery or will need to pay for a private nurse to care for them during their stay.
In order to reach a decision on whether you may or may not be suitable to complete a procedure and to allow our plastic
surgeons to make recommendation on the best plastic surgery procedure for you, we request that you provide
photographs for the surgeon to evaluate. Please follow the examples below.
PLEASE NOTE: You will need to provide images for every procedure you have requested. For example if you are enquiry
about breast Augmentation and Liposuction you will need to provide images for your Breasts and Body. Please insure that
the images are clear and are taken by another party where possible as this will ensure that you will receive a more accurate
I understand that submitting this information and using the services of Inspire Cosmetics means that I agree to the following…
PROVISION OF SERVICES. Inspire Cosmetics acts as a healthcare intermediary or a booking platform where the Patient may avail its services toobtain surgeries and treatment. Such booking services may be availed by the Patients for the treatment of their respective choice and preferred
doctor or surgeon in the mode specified by Inspire Cosmetics. Any provisioning of service or any content made available by or through Inspire
Cosmetics shall not constitute medical advice or a treatment or an opinion and any content available for any doctor or surgeon should not be
considered an endorsement or marketing of the skills, practice or profession of any particular doctor or surgeon or any institution. By signing this
document, physically or online, you understand that you will make final choice as to who will carryout your needed or desired surgery, and that
Inspire Cosmetics and it’s / directors / employees are not responsible for your decision and any final outcomes of surgery. All surgeries are subject
to medical approval.
PAYMENT. Inspire Cosmetics shall accept advance payment for the provisioning of such services when you book an appointment or day of surgery.
Such payment shall be inclusive of the basic booking charges as well the Service Fee (surgeon or doctor’s fee and surgery/treatment charges)
specified by the particular doctor or surgeon. The final price for surgery can only be quoted once the client has had their face to face consult directly
with the surgeon. Full payment is required 28 days before surgery. Bookings made within 28 days of surgery day are considered a “Rush Booking”.
This requires payment in full to reserve a booking. Cancellation of a surgery within 28 days of surgery incurs $1500 fee. This includes a patient
doing anything that prevents them from having surgery on the day. To move a booking date, will incur $300 fee only if a replacement patient can
be found. Otherwise it is a cancellation and $1500 applies. Accommodation, flights & any other travel should NOT be booked until after the client
has had their Skype or face to face consultation with the surgeon directly. Procedure dates are subject to change and therefore the surgeon or
Inspire Cosmetics will not be held responsible for the cost of any travel that has been booked prior to the clients Skype or face to face consultation.
NO MEDICAL ADVICE. Any content or service or medical information that you or the Patient will avail from Inspire Cosmetics and its employees,
affiliates, sponsors, partners, advertisers, licensors or otherwise is for information purpose only and it comes from independent healthcare specialists.
No part of such information is intended to be a replacement or substitute for any medical advice, surgical procedure or treatment, diagnosis or
otherwise. Advice given via an online surgical assessment PDF from surgeons (even when given to you by Inspire Cosmetics on behalf of the surgeon)
is between you and the surgeon, and you can question any part during your consultation with the surgeon. Clients should be aware that if the
following conditions are not adhered to then they will be liable for any medical/surgical complications that may arise: Smokers who do not cease
smoking 4 weeks prior to, and 4 weeks after their surgery; Clients who drink alcohol 1 week prior to their surgery and for the complete post-operative
period until they have ceased their course of antibiotics or as advised by their surgeon; Clients should not eat or drink for at least 8 hours
before the scheduled surgery; Clients should cease taking dietary supplements, Aspirin, Ibuprofen and vitamins at two weeks before your scheduled
surgery. If clients are taking any other medications, they should notify their coordinator and surgeon of this before arriving for surgery. Phone conversations
and emails from Inspire Cosmetics or its representative are not a confirmation of the surgery or treatment plan that will be performed,
as this will only be confirmed after consultations directly with the surgeon. PRIVACY. You approve that the information on this form along with the
photos attached will be handled by Inspire Cosmetics and it’s staff. It will also be passed on to surgeons, partners and their employees for them to
review. You have also reviewed all the information on this form and verified that it is correct, and understand that surgeons will use this to give you
RELATIONSHIP CREATED. Any use of facilities or services or any communication made, in pursuance of this Agreement, between you and Inspire
Cosmetics is not intended to create a Doctor-Patient relationship. Inspire Cosmetics is only intended to provide a platform for booking of services
of the surgeons or doctors according to the needs and requirements of the Patients and it cannot be construed to be an independent healthcare
institution or specialist providing any medical advice or support. NO LIABILITY: Inspire Cosmetics holds no personal or fiduciary duty to the Patient
in relation to any surgery or treatment services provided by the professionals, surgeons or doctors. Inspire Cosmetics shall make best possible
efforts to provide all the services in the most commercial and professional manner but it shall have no control over the feasibility or availability of
any Doctor or Surgeon at the particular time for which booking is done by the Patient. Inspire Cosmetics cannot be held liable and responsible for
any cancelled, delayed or otherwise unfulfilled appointments or any loss or injury resulting therefrom unless it occurs due to the fault or negligence
of surgeons, their companies or its staff.
I agree to the terms and conditions of services on this website.