Forms - Only The Baddest Post Op Recovery Suites

Client Liability Waiver & Release

Financial Responsibility

Check-In & Check-Out

Our check-in time is 3 pm and our check-out time is 12 pm. If you need to check-in early or check-out late, there is a surcharge and it is based upon availability. Please plan your flights accordingly. Even if your flight is in the morning on your final day, you will still have to pay for that day. ◦ I understand that if an early check-in is available, I will be charged a fee of $50 to have access to a bed. Once check out time approaches, I understand that I will need to leave the premises or pay a late checkout fee, not exceeding $50. You may stay in the common area and there is a $50 fee to stay in a room (based on availability). Late check-out does not include transportation to the airport and I understand it will be my responsibility to transport myself to the airport any time after 8:00 pm. ◦ I understand that check-in time closes at 9:00 PM and that I will not be granted access to the facility after this time. ◦ I understand if I check in after surgery, I am not entitled to a bed until check-in time which is 3:00 PM.

Meals

Airport Transportation

◦ I understand that Only The Baddest offers shared transportation service, and does not offer private car service, wait times can be up to sixty minutes. ◦ Only The Baddest does NOT transport pickups from Hotels, Airbnb, or any alternative locations. ◦ Transportation is reserved solely for patient use and is for transportation to Austin Airport and Surgery Centers. ◦ Please be aware that check-in is at 2:00pm and check-out 11:00am. We get you to the airport at least two hours before your flight. However, if your flight is later in the evening, we will still leave no later then 11:00am to drop you off at the airport. So please adjust your flight accordingly. Please note, Only The Baddest post op recovery does not allow check-ins after 9:00PM. If your arrival time is outside of the and times, we do offer transportation, you are responsible for absorbing the cost of transportation to our facility. *If your Pre-Op appointment is on the same day as your incoming flight, we will pick you up and take you to your Pre-Op appointment. This depends on if we are picking up several people within a 60 minute timeframe.

Medical Risks and Responsibility

Only The Baddest is not a medical facility and is a service to facilitate my recovery, monitor my recovery, and follow my Doctors discharge instructions. ◦ Further, I understand that my medical care, at all times, and in all circumstances remains the responsibility of the surgeon who performed my surgery. ◦ I understand that only my surgeon is authorized to write prescriptions for me and to determine outpatient recovery care is appropriate for my particular recovery needs. ◦ I understand that my surgeon is the only party with authority to order and perform post-operative medical treatment and he or she reserves the right, alone, to order my hospitalization, if that is the level of care I require. ◦ I further understand that my surgeon is the only party authorized to determine the level of post-operative care needed following my procedure, including whether discharging me to a non-medical facility, such as home or Only The Baddest, is appropriate. ◦ I understand that I may be unsteady on my feet following surgery and I agree to request assistance getting out of bed for the first 24-hrs following surgery. In addition, while on pain medication, I agree to remain in my recovery suite at Only The Baddest unless accompanied by a friend, family member or Only The Baddest caregiver. ◦ In addition, I fully understand that it is MY responsibility to check with my surgeon, prior to my surgery date, for verification on which over-the-counter AND prescription medications I may take while recovering at Only The Baddest. ◦ I agree to ONLY bring over-the-counter & prescription medications, to Only The Baddest, which my surgeon has verified I may safely restart on arrival to the facility. I understand that it is my responsibility to place ALL approved medications, BOTH prescription and over-the-counter, in ONE MEDICATION BAG and store it in the safe provided by Only The Baddest. Only The Baddest does not administer medication and is limited to reminding you about your medication. ◦ Furthermore, I hereby agree to indemnify and hold harmless Only The Baddest and all of its owners, agents, officers, directors, employees and affiliates from and against any and all loss, liability, damage, cost, expense (including reasonable attorneys’ fees and disbursements and costs of investigation), judgment, charge, fine, interest, penalty or assessment  resulting from, arising out of, or relating to, any act, omission or state of facts and any demand, action, suit, proceeding, claim, assessment, judgment or settlement or compromise, whether known or unknown, of any kind whosoever that I may sustain in connection with choosing not to comply with Only The Baddest medication policy stated here.

Medications & Prescriptions

• Additional medical supplies cost are absorbed by you. Any additional medical supplies will accrue a fee. ◦ We encourage you to bring cash to purchase your prescriptions. If for some reason you do not have cash or your method of payment fails and we must pay for your prescriptions, we have a 3% transaction fee that is added to the cost of your prescriptions. ◦ Prescription drop off concludes at 5:00 PM and prescriptions will be taken to the pharmacy the following morning. The only exception is if the prescription was given on the day of surgery. ◦ Only The Baddest Drivers are only permitted to go to Walgreens or Cvs to fill prescriptions. This is to avoid any delays with filling your prescriptions. You will have to provide your own transportation to an alternate pharmacy should you choose to decline the services at Walgreens Pharmacy or Cvs. ◦ I understand it may take up to 8 hours to fill my prescriptions and Only The Baddest has no control over the given times at the pharmacy. ◦ Again, I agree to ONLY bring over-the-counter & prescription medications, to Only The Baddest, which my surgeon has verified I may safely restart on arrival to the facility. ◦ Again, I hereby agree to indemnify and hold harmless Only The Baddest and all of its owners, agents, officers, directors, employees and affiliates from and against any and all loss, liability, damage, cost, expense (including reasonable attorneys’ fees and disbursements and costs of investigation), judgment, charge, fine, interest, penalty or assessment resulting from, arising out of, or relating to, any act, omission or state of facts and any demand, action, suit, proceeding, claim, assessment, judgment or settlement or compromise, whether known or unknown, of any kind whosoever that I may sustain in connection with choosing not to comply with Only The Baddest’ medication policy stated here.

No Smoking Policy

• I understand that Only The Baddest has a strict NO SMOKING policy and I will be fined $500 if found smoking in my room. I understand that smoking causes significant detriment to my body’s ability to heal and greatly increases my risk of post-op complications. I hereby agree NOT to smoke while at Only The Baddest. ◦ I also agree NOT to request the assistance of a Only The Baddest staff member, hotel employee or any other person to assist me outside to smoke. ◦ Should I decide to smoke and breach this contract, I am doing so at my own risk. I hereby agree to indemnify and hold harmless Only The Baddest and all of its owners, agents, officers, directors, employees and affiliates from and against any and all loss, liability, damage, cost, expense (including reasonable attorneys’ fees and disbursements and costs of investigation), judgment, charge, fine, interest, penalty or assessment resulting from, arising out of, or relating to, any act, omission or state of facts and any demand, action, suit, proceeding, claim, assessment, judgment or settlement or compromise, whether known or unknown, of any kind whosoever that I may sustain in connection with choosing to smoke while at Only The Baddest.

Transportation

• I hereby assume all risk and personal injury, sickness, death, damage, and expenses as a result of participation in transportation activities involved with Only The Baddest. Further, authorization and permission are hereby given to Only The Baddest to furnish any necessary transportation, and I hereby agree to hold harmless and indemnify Only The Baddest and all of its owners, agents, officers, directors, employees, and affiliates for any liability sustained by services provided by Only The Baddest as a result of the negligent. Willful or intentional acts of Only The Baddest including expenses incurred attendant thereto and hereby give permission to hospitalize and hereby authorize medical treatment, including but not limited to emergency surgery or medical treatment, and assume the responsibility of all medical bills if any. I understand that this is a legally binding release and consent. ◦ I have carefully read this Release of Liability and Consent for Transportation and Medical Treatment policy, outlined here and fully understand its contents. Being aware of said contents, I sign of my own free will. ◦ I understand that whenever myself, a family member or friend will be transported, that I hereby release and hold Only The Baddest and all of its owners, agents, officers, directors, employees and affiliates harmless from any and all loss, liability, damage, cost, expense (including reasonable  attorneys’ fees and disbursements and costs of investigation), judgment, charge, fine, interest, penalty or assessment resulting from, arising out of, or relating to, any act, omission or state of facts and any demand, action, suit, proceeding, claim, assessment, judgment or settlement or compromise, whether known or unknown, of any kind whatsoever that I, a family member or a friend, may sustain in connection with the services provided to me by Only The Baddest or any of the foregoing.

Cancellations

• In order to provide the best experience possible for our guests, if you need to cancel your stay with us for any reason, please email us as we need the cancellation in writing. ◦ You must cancel at least one month before your check-in date, the deposit is non-refundable. ◦ If you choose to reschedule, you must contact us two weeks prior to your check-in date. ◦ Again, you are encouraged to use your deposit to reschedule your stay for a later date . If you have not contacted us within the two-week timeframe to reschedule, you forfeit not only your deposit but all monies paid. You may reschedule for anytime within the next 12 months based on availability. ◦ No changes can be made to your reservation once you check in. If you must depart early, you forfeit your deposit and all monies paid. ◦ If your full balance is not paid within 1 weeks of check-in you must contact us to make a payment or your reservation will be canceled and you forfeit any monies paid. If we do not receive prior notice based on our cancellation policy you will forfeit your deposit or any monies paid. ◦ You must submit all required forms, financial obligations, and provide flight information at least 7 days prior to your arrival or we reserve the right to cancel your reservation and you forfeit all monies paid. ◦ We are unable to plan for your stay or transportation without your flight details.

Loss & Damage

Code of Conduct

• Only The Baddest Post Op is a Recovery home and we promote an environment that is conducive to healing. We require that you speak in a low tone while within the facility and be considerate of other guests and our staff. We do not allow any profanity inside or on the premises of our facility. We require that you are respectful towards all guests and our staff at all times. Additionally, you must use headphones while on FaceTime or any video call. We do not allow the use of speakerphone in order to preserve the peace of our other guests. We do allow you to do video recording, going on “live” on social media but only with the acknowledgment of the owner of Only The Baddest. Failure to follow this code of conduct will result in removal from our facility and you will forfeit all the monies paid. • In consideration of the foregoing, I still elect to utilize the services of Only The Baddest. I agree to indemnify and hold harmless Only The Baddest and all of its owners, agents, officers, directors, employees and affiliates from and against any and all loss, liability, damage , cost, expense (including reasonable attorney’s fees and disbursements and costs of investigation), judgment, charge, fine, interest, penalty or assessment resulting from, arising out of, or relating to, any act, omission or state of facts and any demand, action, suit, proceeding, claim, assessment, judgment or settlement or compromise, whether known or unknown, of any kind whatsoever that I may sustain in connection with the services provided to me by Only The Baddest or any of the foregoing.

Yes, I acknowledge that I have read and understood the terms outlined in Only The Baddest Post Op Recovery Suites Liability Waiver & Release document

Yes

Yes, I understand, that I must cancel within one month, and deposits are non-refundable and that if I choose to reschedule, I must contact Only The Baddest Post Op Recovery Suites within two weeks prior to my scheduled check-in date.

Yes

Yes, I understand, if I have not contacted Only The Baddest Post Op Recovery Suites within the two weeks prior to scheduled check-in date, I forfeit not only my deposit but all monies paid.

Yes

Yes, I understand, that if my full balance is not paid within 7 days of scheduled check-in I must contact Only The Baddest Post Op Recovery Suites to make payment or my reservation will be canceled and I forfeit any monies paid.

Yes

Yes, I understand, that Only The Baddest Post Op Recovery Suites is not a Medical facility and does not provide Medical treatment.

Yes

Date of Birth *

Signature *

By electronically signing this document, you agree to the terms established above.

Date

Phone#

Email

File Upload *

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