WAIVER OF LIABILITY

The New York Center for Facial Plastic and Laser Surgery / Gold Coast Surgical Facility, complies with all applicable CDC sanitation guidelines. Despite these precautions, due to the unique nature of the COVID-19 novel coronavirus pandemic, no in-person social interaction can be guaranteed to be completely free from the risk of transmission.

I acknowledge the above and consent to the risk of potential coronavirus/COVID19 exposure, illness, and even death. I understand such exposure could occur before, during, or after my visit

and all of the staff at The New York Center for Facial Plastic and Laser Surgery/Sean Alemi, MD, Park Avenue Aesthetic/Gold Coast Surgical Facility to proceed with the same.

I have been offered the opportunity to reschedule or cancel today’s visit and choose to proceed voluntarily. All of my questions have been answered satisfactorily.

QUESTIONNAIRE