Credit Card Authorization Form
The required deposit will be applied towards the total cost of your services, ensuring that your appointment is reserved exclusively for you.
Cardholder Information
I hereby authorize CG Cosmetic Surgery to process a charge on my credit card and/or withdraw funds from the specified account. This transaction will be applied towards my outstanding balance. I understand and acknowledge that my deposit of $1,000.00 is NON-REFUNDABLE. I am also aware that it is mandatory to present the credit card used for this transaction on the day of my services. Failure to do so grants the Accounting Department the authority to CANCEL my scheduled services.
I agree to terms & conditions and consent to receive text messages from CG Cosmetic regarding their products and services. I understand that this consent can be withdrawn at any time and is not a condition of any purchase or service.