Surgery Intake Form

Your in the right place!

Thank you for considering The Posh Cosmetic Concierge for your recovery care. We’re honored to support you during such an important moment in your healing journey.
Please Note:

The Posh Cosmetic Concierge is a luxury, mobile post-operative recovery service serving the Tri-State area (New Jersey, New York City, and Pennsylvania). All services are provided in the privacy of your hotel, Airbnb, or approved lodging.

To keep your recovery calm and comfortable, one companion is permitted during services.
We offer a range of private recovery care options designed to support you with comfort, discretion, and intention. A non-refundable deposit is required at the time of booking to secure your requested dates and will be applied toward your total balance. Remaining balances are due no later than 14 days prior to the start of care.

Surgery center pick-up and/or post-operative appointment transportation includes up to 25 complimentary miles. Any additional mileage will be billed accordingly.

Your only job is to rest and recover — we’ll handle the details. Let’s plan your recovery!
Top Tier 3 days- $4,750Expensive Taste 2 days-$1,550So Posh- Hourly Only (6 Hrs-$750, 8 Hrs-$950, 10 Hours- $1,150)R!ch Girl$-Sx SisterVirtual recovery guidance ( 7 Day-$2,000, 5 Day-$1500, 3Day-$975)
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Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Place of Lodging? ( Recovery Location)*
Surgical Procedure *
General AnesthesiaLocal Anesthesia
Doctor*
Surgery Center and Location *
Surgery Date*

MonthDayYear
Date
Surgery Instagram Name
Emergency Contact Full Name *
Emergency Contact Phone Number *
Any Medical Condition(s): If none enter N/A*
Traveling with a Companion?*
Customized Meal Prep (grocery shop and cook) - $150 per dayTransportion (airport pick up/drop off, pre-op/post-op, massages) - Call for pricingZero Gravity BBL Chair Rental -$25 per dayThe Posh Life- CBD Hydration Cocktails (6) $55
Please allow 24 hrs or the next business day for a response

Thank You!
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Your in the right place!

Please allow 24 hrs or the next business day for a response