We are 100% committed to the health and well-being for everyone. We are doing everything we can to keep potential exposure out of our office.

As part of the  local and state guidelines you must answer no to all the following questions each time you enter Pua Manu Medspa.

• Not present a fever over 100 F/ 37 C.
• Not presenting cold, cough, difficulty breathing muscle pain, headache, loss of taste/smell or pink eye in past 5 days.
• Not in contact with anyone with these symptoms in the past 5 days.
• Not in contact with anyone diagnosed with COVID-19, sick and quarantined, in the past 5 days.

All information above is true. I may be asked again when I arrive for my appointment. 

ALL PATIENTS AND STAFF ARE REQUIRED TO:

 

• Stay home if you are sick or are exhibiting symptoms of illness such as a fever or persistent cough.
• Face mask are required to enter the Spa.
• Refrain from shaking hands or other touching rituals.
  Wash hands for 60 seconds with soap and warm water prior to treatment or use hand sanitizer.
• Refrain from eating or drinking while in the Spa, face mask should not be removed.

 

 

Pua Manu MedSpa HIPAA Authorization for Use or Disclosure of Health Care Information By signing this form, I authorize the use and disclosure of health information as described below:

• Description of Information: Submission of health and personal information to all insurance companies involved in the payment of the office visit or any other entity responsible for the payment of the visit.
• Name or class of person(s) authorized to make the used or disclosure: Any office employee directly involved in the care or claim submission to the insurance companies. WE WILL NOT RELEASE YOUR PERSONAL HEALTH INFORMATION TO ANYONE WITHOUT YOUR CONSENT. Please list anyone you would like to authorize release of your Personal Health Information to below:
(ex: mother, father, legal guardian, caregiver, etc.)

• Date or event when authorization expires: Indefinite from the date of this signed document. 

I understand that I have the right to revoke this authorization, in writing at any time, except (1) where uses or disclosures have already been made based upon my original permission, or (2) the authorization was obtained as a condition in securing insurance coverage and the insurer by law has the right to contest a claim or the insurance policy. I understand that the use and disclosures already made based upon my original permission cannot be taken back. To revoke the authorization, I must do so in writing and send it to: Nancy Chen, M.D., Kapolei Eye Care, at P.O. Box 75625, Kapolei, HI 96707.

I understand that it is possible that information used or disclosed with my permission may be redisclosed by the recipient and no longer protected by the Federal Privacy Standards. I may receive a copy of the full HIPAA disclosure for review upon my request.

I understand that necessary photos will be taken before, during and after the course of my treatments for medical purposes and to evaluate treatment effectiveness. I understand that my photos will be kept confidential in my electronic patient record. If you refuse to take any photos, please understand that we will not be able to perform any treatments on you.

Rescheduling/Cancellation Policy

If you need to reschedule or cancel, please contact us 24 hours in advance of your scheduled time. If our office is closed that day, please leave a message with your name and appointment being cancelled. All rescheduling/cancellations with less than 24 hours' notice are subject to a $50 fee. This courtesy enables us to compensate our employees for their time and maintains a higher availability of our time for you as well as others. By scheduling an appointment, you are agreeing to our rescheduling/cancellation policy. Patients arriving more than 10 minutes late may result in a shortened appointment or a cancellation if there is not enough time to complete the procedure. No penalty will apply to an illness or suspected illness.  

Appointment and check-in Policy

Arriving late will deprive you of valuable treatment time. To avoid delaying the next guest, your treatment will end on time and you will be responsible for the full treatment cost. Arriving more than 10 minutes late may result in cancellation fee and $50

fee. We encourage you to schedule two weeks in advance to reserve the most convenient time for your schedule.

We have implemented a contactless check-in procedure. Upon arriving please text or call us to confirm your arrival and wait in your car. If you haven't completed your consent form(s) please do so while you are waiting. A consent form will need to be completed at each visit. We will text or call you when the treatment room is ready. 

No-Show Policy

 

We schedule our appointments so that each patient receives the right amount of time to be seen by our physician and staff. As a courtesy, and to help patients remember their scheduled appointments, Pua Manu MedSpa may send a text message and/ call reminder in advance of the appointment time. 

If you cannot keep your appointment, please contact us so we may reschedule you, and accommodate those patients who are waiting for an appointment.

 

As a courtesy to our office as well as to those patients who are waiting to schedule with the physician and staff, please give us at least 24 hours notice. If you do not cancel or reschedule your appointment with at least 24 hours notice, we may assess a $50.00 “no-show” service charge. This “no-show charge” will be credited to you when you reschedule. 

 

I understand the “no-show” policy of PuaManu MedSpa and agree to provide a credit card number, which may be charged $50.00 for any no-show of a scheduled appointment. I understand that I must cancel or reschedule any appointment at least 24 hours in advance in order to avoid a potential “no-show charge” to my credit card company. 

Product Return Policy

Some unopened products may be returned within 10 days of purchase with receipt. Treatment series, packages and gift certificates are nonrefundable. Any approved refunded amounts for incomplete and/or cancelled treatments will be charged at the the regular/full price.

Gift Certificate Policy

Gift certificates are non-refundable and cannot be redeemed for cash or gratuities.

Treatment Outcomes

It is virtually impossible to predict results as they vary from patient to patient. I understand that although good results are expected, there cannot be any guarantee that I will be completely satisfied by the outcome. I understand that results can vary and that no guarantee, neither expressed nor implied, has been or will be, given to me regarding my results. I understand that I may need more than one treatment to see results.

Photos

I understand that necessary photos will be taken before, during and after the course of my treatments for medical purposes and to evaluate treatment effectiveness. I understand that my photos will be kept confidential in my electronic patient record. If you refuse to take any photos, please understand that we will not be able to perform any treatments on you.