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Grant Applicant / Recipient Agreement

Last Date of Board Approval: February 5th, 2019.

As an applicant, or potential recipient of a Cosmetic Surgery Grant, You agree to the following terms:

  1. You understand that any funds or considerations which may be provided to You can only be applied toward the cosmetic surgery treatment plan presented by an approved clinic that participates in this Program.

  2. You understand that You are financially responsible for the portion of your surgery that is not covered by the Grant.

  3. ​If requested, you agree to demonstrate your financial ability to complete payment for the portion of the surgery plan not covered by the Grant.

  4. You agree that we may provide your information to authorized surgeons, their respective staff, third-party agents, volunteers or subsidiaries for the purpose of booking your consultation and to communicate with You regarding the status of Your grant application; and/or to perform functions such as customer service, etc.

  5. You agree to permit us to contact you and communicate with you via telephone, email, text messaging and regular mail.

  6. You understand that Grants are not available for any designated health services that are payable by federal health care programs.

  7. You certify that You are at least 18 years of age.

Submitting an application for a Cosmetic Surgery Grant confirms you have read, understand and agree to the terms of these guidelines and agree to comply with them.

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