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Company Policies

Company Policies:

Appointment Schedule/Reschedule/Cancellation/No-Show Policy

Thank you for trusting MirroRX with your care. We value your time as much as the next client and as our own. Last-minute reschedules, cancellations, and no-shows are a reality that results in missed opportunities to move another client into a treatment chair from an appointment waitlist leading to a lose-lose situation. In order to better serve our clients, we utilize a detailed appointment policy. Please read carefully.


Scheduling appointments requires a $50 service deposit which will be applied toward any appointment charges.


Should you need to reschedule or cancel an appointment, please contact MirroRX as soon as possible. We ask you to reschedule or cancel no later than 2 business days (48 business hours) prior to your schedule. For example, if your appointment is on Friday afternoon, you should call MirroRX to cancel or reschedule no later than Wednesday morning. 


Rescheduling or canceling an appointment within the 2 business day time frame of a scheduled appointment may be subject to a cancellation fee.


Any client who fails to show up for an appointment without notice is considered a ‘no show’ and subject to a forfeit deposit.


Any client arriving more than 15 minutes after the scheduled time and unable to be seen will be considered a ‘same day cancellation’ and subject to forfeit deposit.


Any client with three or more ‘no shows’ in a calendar year may be dismissed from MirroRX.

Clients with three or more ‘same day cancellations’ in a calendar year may be dismissed from MirroRX.



We understand there may be times when an unforeseen emergency occurs, and you may not be able to keep your scheduled appointment or give us advanced notice. If you have such an emergency, please contact MirroRX. to discuss your situation further.


We do not offer refunds for treatments, products, or services. In the unlikely case that you are unhappy with your MirroRx experience, we encourage you to work with our provider to determine if a follow-up appointment might satisfy your concerns.


Additional or revisional treatments or treatments that address complications

Although we anticipate good results based on the best medical data and previous patient outcomes, aesthetic practice is not an exact science.  We cannot guarantee or warranty the outcome of any treatment or service. In some cases, additional or follow-up treatments of the same or different types may be necessary to achieve the desired effect. These could result in additional charges, for which you are responsible.



We accept credit cards – Visa, MasterCard, American Express, and Discover. Credit Card payments incur a processing fee. We also accept Square Cash Payments for all in-office treatments. Payment in full is due at the time of service. Some memberships and package pricing are available. Ask for details. 

Rights Reserved

MirroRx makes periodic updates to policies and communicates these changes via our website and select social media. We reserve the right to change our policies without notice.

Children Policy

Due to safety reasons, no children under the age of 16 are allowed at MirroRx during appointments.


Dog Policy

We love dogs and all have them! Due to safety regulations, no dogs are allowed at MirroRx.

Medical Advice Disclaimer


The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition or treatment before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.



We understand the importance of privacy and are committed to maintaining the confidentiality of your medical
information. We make a record of the medical care we provide and may receive such records from others. We use
these records to provide or enable other healthcare providers to provide quality medical care, to obtain payment for
services provided to you as allowed by your health plan, and to enable us to meet our professional and legal
obligations to operate this medical practice properly. We are required by law to maintain the privacy of protected
health information and to provide individuals with notice of our legal duties and privacy practices with respect to
protected health information. This notice describes how we may use and disclose your medical information. It also
describes your rights and our legal obligations with respect to your medical information. If you have any questions
about this Notice, please contact our Privacy Officer listed above.

A. How This Medical Practice May Use or Disclose Your Health Information
This medical practice collects health information about you and stores it in a chart and on a computer. This is your
medical record. The medical record is the property of this medical practice, but the information in the medical record
belongs to you. The law permits us to use or disclose your health information for the following purposes:

1. Treatment. We use medical information about you to provide your medical care. We disclose medical
information to our employees and others who are involved in providing the care you need. For example, we
may share your medical information with other physicians or other healthcare providers who will provide
services that we do not provide. Or we may share this information with a pharmacist who needs it to
dispense a prescription to you, or a laboratory that performs a test. We may also disclose medical
information to members of your family or others who can help you when you are sick or injured.

2. Payment. We use and disclose medical information about you to obtain payment for the services we
provide. For example, we give your health plan the information it requires before it will pay us. We may also
disclose information to other healthcare providers to assist them in obtaining payment for services they
have provided to you.

3. Health Care Operations. We may use and disclose medical information about you to operate this medical
practice. For example, we may use and disclose this information to review and improve the quality of care
we provide, or the competence and qualifications of our professional staff. Or we may use and disclose this
information to get your health plan to authorize services or referrals. We may also use and disclose this
information as necessary for medical reviews, legal services, and audits, including fraud and abuse detection
and compliance programs and business planning and management. We may also share your medical
information with our " business associates such as our billing service, who perform administrative services
for us. We have a written contract with each of these business associates that contains terms requiring them
to protect the confidentiality and security of your medical information. Although federal law does not protect
health information that is disclosed to someone other than another healthcare provider, health plan,
healthcare clearinghouse, or one of their business associates, California law prohibits all recipients of
healthcare information from further disclosing it except as specifically required or permitted by law. We may
also share your information with other healthcare providers, healthcare clearinghouses, or health plans that
have a relationship with you when they request this information to help them with their quality assessment
and improvement activities, their patient-safety activities, their population-based efforts to improve health or
reduce health care costs, protocol development, case management or care coordination activities, their
review of competence, qualifications, and performance of health care professionals, their training programs,
their accreditation, certification or licensing activities, their activities related to contracts of health insurance
or health benefits, or their health care fraud and abuse detection and compliance efforts. We may also share
medical information about you with the other health care providers, health care clearinghouses, and health
plans that participate with us in " organized health care arrangements; (OHCAs) for any of the OHCAs
health care operations. OHCAs include hospitals, physician organizations, health plans, and Other entities
which collectively provide health care services. A listing of the OIICAs we participate in is available from the
Privacy Official.

4. Appointment Reminders. We may use and disclose medical information to contact and remind you about
appointments. If you are not home, we may leave this information on your answering machine or in a
message left with the person answering the phone.

5. Sign In Sheet. We may use and disclose medical information about you by having you sign in when you
arrive at our office. We may also call out your name when we are ready to see you.

6. Notification and Communication with Family. We may disclose your health information to notify or assist in
notifying a family member, your personal representative, or another person responsible for your care about
your location, your general condition, or, unless you have instructed us otherwise, in the event of your death.
In the event of a disaster, we may disclose information to a relief organization so that they may coordinate
these notification efforts. We may also disclose information to someone who is involved with your care or
helps pay for your care. If you are able and available to agree or object, we will give you the opportunity to
object prior to making these disclosures, although we may disclose this information in a disaster even over
your objection if we believe it is necessary to respond to the emergency circumstances. If you are unable or
unavailable to agree or object, our health professionals will use their best judgment in communication with
your family and others.

7. Marketing. Provided we do not receive any payment for making these communications, we may contact you
to encourage you to purchase or use products or services related to your treatment, case management or
care coordination, or to direct or recommend other treatments, therapies, health care providers, or settings of
care that may be of interest to you. We may similarly describe products or services provided by this practice
and tell you which health plans we participate in, We may receive financial compensation for talking with you
face-to-face, to provide you with small promotional gifts, or to cover our cost of reminding you to take and
refill your medication or otherwise communicate about a drug or biologic that is currently prescribed for you,
but only if you either: (I) have a chronic and seriously debilitating or life-threatening condition and the
communication is made to educate or advise you about treatment options and otherwise maintain
adherence to a prescribed course of treatment, or (2) you are a current health plan enrollee and the
communication is limited to the availability of more cost-effective pharmaceuticals. If we make these
communications while you have a chronic and seriously debilitating or life-threatening condition, we will
Provide notice of the following in at least 14-point type: (I) the fact and source of the remuneration; and (2)
your right to opt out of future remunerated communications by calling the communicator & and toll-free number.
We will not otherwise use or disclose your medical information for marketing purposes or accept any
payment for other marketing communications without your prior written authorization. The authorization will
disclose whether we receive any financial compensation for any marketing activity you authorize, and we will
stop any future marketing activity to the extent you revoke that authorization.

8. Sale of Health Information. We will not sell your health information without your prior written authorization.
The authorization will disclose that we will receive compensation for your health information if you authorize
us to sell it, and we will stop any future sales of your information to the extent that you revoke that

9. Required by Law. As required by law, we will use and disclose your health information, but we will limit our
use or disclosure to the relevant requirements of the law. When the law requires us to report abuse, neglect, or domestic violence, or respond to judicial or administrative proceedings, or to law enforcement officials, we
will further comply with the requirement set forth below concerning those activities.

10. Public Health. We may, and are sometimes required by law to disclose your health information to the public
health authorities for purposes related to preventing or controlling disease, injury, or disability; reporting
child, elder, or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and
Drug Administration problems with products and reactions to medications; and reporting disease or infection
exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform
you or your personal representative promptly unless in our best professional judgment, we believe the
notification would place you at risk of serious harm or would require informing a personal representative we
believe is responsible for the abuse or harm.

11. Health Oversight Activities. We may, and are sometimes required by law to disclose your health information
to health oversight agencies during the course of audits, investigations, inspections, licensure, and other
proceedings, subject to the limitations imposed by federal and California law.

12. Judicial and Administrative Proceedings. We may, and are sometimes required by law, to disclose your
health information in the course of any administrative or judicial proceeding to the extent expressly
authorized by a court or administrative order, We may also disclose information about you in response to a
subpoena, discovery request, or other lawful process if reasonable efforts have been made to notify you of
the request and you have not objected, or if your objections have been resolved by a court or administrative

13. Law Enforcement. We may, and are sometimes required by law, to disclose your health information to a law
enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or
missing person, complying with a court order, warrant, grand jury subpoena, and other law enforcement

14. Coroners. We may, and are often required by law, to disclose your health information to coroners in
connection with their investigations of deaths.

15. Organ or Tissue Donation. We may disclose your health information to organizations involved in procuring,
banking or transplanting organs and tissues.

16. Public Safety. We may, and are sometimes required by law, to disclose your health information to
appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a
particular person or the general public.

17. Proof of Immunization. We will disclose proof of immunization to a school where the law requires the school
to have such information prior to admitting a student if you have agreed to the disclosure on behalf of yourself
or your dependent.

18. Specialized Government Functions. We may disclose your health information for military or national security
purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.

19. Workers' Compensation. We may disclose your health information as necessary to comply with workers'
compensation laws. For example, to the extent your care is covered by workers; compensation, we will make
periodic reports to your employer about your condition. We are also required by law to report cases of
occupational injury or occupational illness to the employer or workers' compensation insurer.

20. Change of Ownership. In the event that this medical practice is sold or merged with another organization,
Your health information/record will become the property of the new owner, although you will maintain the
right to request that copies of your health information be transferred to another physician or medical group.

21. Breach Notification. In the case of a breach of unsecured protected health information, we will notify you as
required by law. If you have provided us with a current email address, we may use email to communicate
information related to the breach. In some circumstances, our business associate may provide the
notification. We may also provide notification by other methods as appropriate.

22. Research. We may disclose your health information to researchers conducting research with respect to
which your written authorization is not required as approved by an Institutional Review Board or privacy
board, in compliance with governing law.
B. When This Medical Practice May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, this medical practice will, consistent with its legal obligations,
not use or disclose health information that identifies you without your written authorization. If you do authorize this
medical practice to use or disclose your health information for another purpose, you may revoke your authorization in
writing at any time.

C. Your Health Information Rights

1. Right to Request Special Privacy Protections. You have the right to request restrictions on certain uses and
disclosures of your health information by a written request specifying what information you want to limit, and
what limitations on our use or disclosure of that information you wish to have imposed. If you tell us not to
disclose information to your commercial health plan concerning healthcare items or services for which you
paid in full out-of-pocket, we will abide by your request, unless we must disclose the information for
treatment or legal reasons. We reserve the right to accept or reject any other request and will notify you of
our decision.

2. Right (Request Confidential Communications. You have the right to request that you receive your health
information in a specific way or at a specific location. For example, you may ask that we send information to
a particular email account or to your work address. We will comply with all reasonable requests submitted in
writing which specify how or where you wish to receive these communications.

3. Right to Inspect and Copy. You have the right to inspect and copy your health information, with limited
exceptions. To access your medical information, you must submit a written request detailing what
information you want access to, whether you want to inspect it or get a copy of it, and if you want a copy,
your preferred form and format. We will provide copies in your requested form and format if it is readily
producible, or we will provide you with an alternative format you find acceptable, or if we can't agree and we
maintain the record in an electronic format, your choice of a readable electronic or hardcopy format. We will
also send a copy to another person you designate in writing. We will charge a reasonable fee that covers
our costs for labor, supplies, postage, and if requested and agreed to in advance, the cost of preparing an
explanation or summary, as allowed by federal and California law. We may deny your request under limited
circumstances. If we deny your request to access your child's records or the records of an incapacitated
adult you are representing because we believe allowing access would be reasonably likely to cause
substantial harm to the patient, you Will have a right to appeal our decision. If we deny your request to
access your psychotherapy notes, you will have the right to have them transferred to another mental health

4. Right to Amend or Supplement. You have a right to request that we amend your health information that you
believe is incorrect or incomplete. You must make a request to amend in writing and include the reasons you
believe the information is inaccurate or incomplete. We are not required to change your health information
and will provide you with information about this medical practice denial and how you can disagree with the
denial. We may deny your request if we do not have the information if we did not create the information
(unless the person or entity that created the information is no longer available to make the amendment), if
you would not be permitted to inspect or copy the information at issue, or if the information is accurate and
complete as is. If we deny your request, you may submit a written statement of your disagreement with that
decision, and we may, in turn, prepare a written rebuttal. You also have the right to request that we add to
your record a statement of up to 250 words concerning anything in the record you believe to be incomplete
or incorrect. All information related to any request to amend or supplement will be maintained and disclosed
in conjunction with any subsequent disclosure of the disputed information.

5. Right to an Accounting of Disclosures. You have a right to receive an accounting of disclosures of your
health information made by this medical practice, except that this medical practice does not have to account
for the disclosures provided to you or pursuant to your written authorization, or as described in paragraphs I
(treatment), 2 (payment), 3 (health care operations), 6 (notification and communication with family) and 18
(specialized government functions) of Section A of this Notice of Privacy Practices or disclosures for
purposes of research or public health that exclude direct patient identifiers, or which are incident to the use
or disclosure otherwise permitted or authorized by law, or the disclosures to a health oversight agency or law
enforcement official to the extent this medical practice has received notice from that agency or official that
providing this accounting would be reasonably likely to impede their activities.

6. You have a right to notice of our legal duties and privacy practices with respect to your health information,
including a right to a paper copy of this Notice of Privacy Practices, even if you have previously requested its
receipt by email.
If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of
these rights, contact our Privacy Officer listed at the top of this Notice of Privacy Practices.

D. Changes to this Notice of Privacy Practices
We reserve the right to amend our privacy practices and the terms of this Notice of Privacy Practices at any time in
the future. Until such amendment is made, we are required by law to comply with this Notice. After an amendment is
made, the revised Notice of Privacy Protections will apply to all protected health information that we maintain,
regardless of when it was created or received. We will keep a copy of the current notice posted in our reception area,
and a copy will be available at each appointment. We will also post the current notice on our website.

E. Complaints
Complaints about this Notice of Privacy Practices or how this medical practice handles your health information should
be directed to our Privacy Officer listed at the top of this Notice of Privacy Practices.
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:

Southeast Region - Atlanta (Alabama, Florida, Georgia, Kentucky,
Mississippi, North Carolina, South Carolina, Tennessee)

Barbara Stampul, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
Sam Nunn Atlanta Federal Center, Suite 16T70
61 Forsyth Street, S.W.
Atlanta, GA 30303-8909
Customer Response Center: (800) 368-1019
Fax: (202) 619-3818
TDD :(800) 537-7697

The complaint form may be found at You will not be
penalized in any way for filing a complaint.
MirroRx by Lorrie effective August 16, 2023

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