drvalaie.com , Pacific Cosmetic and Facelift Center and Dr. Valaie, MD Privacy Policy - Terms and Conditions
This privacy policy has been compiled to better serve those who are concerned with how their 'Personally Identifiable Information' (PII) is being used online. PII, as described in US privacy law and information security, is information that can be used on its own or with other information to identify, contact, or locate a single person, or to identify an individual in context. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website.
What personal information do we collect from the people that visit our blog, website or app?
When ordering or registering on our site, as appropriate, you may be asked to enter your name, email address, phone number or other details to help you with your experience.
When do we collect information?
We collect information from you when you register on our site or enter information through our forms on our site.
How do we use your information?
We may use the information we collect from you when you register, make a purchase, sign up for our newsletter, respond to a survey or marketing communication, filling out forms, surf the website, or use certain other site features in the following ways:
• To administer a contest, promotion, survey or other site feature.
• To ask for ratings and reviews of services or products
• To follow up with them after correspondence (live chat, email or phone inquiries)
Also we use the information from filling out our forms to email your our promotions on a weekly or biweekly matter.
You get to unsubscribe at anytime.
Each promotional email will have unsubscribe link in it.
How do we protect your information?
We do not use vulnerability scanning and/or scanning to PCI standards.
We only provide articles and information. We never ask for credit card numbers.
We do not use Malware Scanning.
Your personal information is contained behind secured networks and is only accessible by a limited number of persons who have special access rights to such systems, and are required to keep the information confidential. In addition, all sensitive/credit information you supply is encrypted via Secure Socket Layer (SSL) technology.
We only collect
We implement a variety of security measures when a user enters, submits, or accesses their information to maintain the safety of your personal information.
All transactions are processed through a gateway provider and are not stored or processed on our servers.
Do we use 'cookies'?
We do not use cookies for tracking purposes
You can choose to have your computer warn you each time a cookie is being sent, or you can choose to turn off all cookies. You do this through your browser settings. Since browser is a little different, look at your browser's Help Menu to learn the correct way to modify your cookies.
If you turn cookies off, Some of the features that make your site experience more efficient may not function properly.that make your site experience more efficient and may not function properly.
Third-party disclosure
We do not sell, trade, or otherwise transfer to outside parties your Personally Identifiable Information.
Third-party links
We do not include or offer third-party products or services on our website.
Google
Google's advertising requirements can be summed up by Google's Advertising Principles. They are put in place to provide a positive experience for users. https://support.google.com/adwordspolicy/answer/1316548?hl=en
We have not enabled Google AdSense on our site but we may do so in the future.
California Online Privacy Protection Act
CalOPPA is the first state law in the nation to require commercial websites and online services to post a privacy policy. The law's reach stretches well beyond California to require any person or company in the United States (and conceivably the world) that operates websites collecting Personally Identifiable Information from California consumers to post a conspicuous privacy policy on its website stating exactly the information being collected and those individuals or companies with whom it is being shared. - See more at: http://consumercal.org/california-online-privacy-protection-act-caloppa/#sthash.0FdRbT51.dpuf
According to CalOPPA, we agree to the following:
Users can visit our site anonymously.
Once this privacy policy is created, we will add a link to it on our home page or as a minimum, on the first significant page after entering our website.
Our Privacy Policy link includes the word 'Privacy' and can easily be found on the page specified above.
You will be notified of any Privacy Policy changes:
• On our Privacy Policy Page
Can change your personal information:
• By emailing us
• By calling us
How does our site handle Do Not Track signals?
We honor Do Not Track signals and Do Not Track, plant cookies, or use advertising when a Do Not Track (DNT) browser mechanism is in place.
Does our site allow third-party behavioral tracking?
It's also important to note that we do not allow third-party behavioral tracking
COPPA (Children Online Privacy Protection Act)
When it comes to the collection of personal information from children under the age of 13 years old, the Children's Online Privacy Protection Act (COPPA) puts parents in control. The Federal Trade Commission, United States' consumer protection agency, enforces the COPPA Rule, which spells out what operators of websites and online services must do to protect children's privacy and safety online.
We do not specifically market to children under the age of 13 years old.
Fair Information Practices
The Fair Information Practices Principles form the backbone of privacy law in the United States and the concepts they include have played a significant role in the development of data protection laws around the globe. Understanding the Fair Information Practice Principles and how they should be implemented is critical to comply with the various privacy laws that protect personal information.
In order to be in line with Fair Information Practices we will take the following responsive action, should a data breach occur:
We will notify you via email
• Within 7 business days
We also agree to the Individual Redress Principle which requires that individuals have the right to legally pursue enforceable rights against data collectors and processors who fail to adhere to the law. This principle requires not only that individuals have enforceable rights against data users, but also that individuals have recourse to courts or government agencies to investigate and/or prosecute non-compliance by data processors.
CAN SPAM Act
The CAN-SPAM Act is a law that sets the rules for commercial email, establishes requirements for commercial messages, gives recipients the right to have emails stopped from being sent to them, and spells out tough penalties for violations.
We collect your email address in order to:
• Send information, respond to inquiries, and/or other requests or questions
To be in accordance with CANSPAM, we agree to the following:
• Not use false or misleading subjects or email addresses.
• Include the physical address of our business or site headquarters.
• Monitor third-party email marketing services for compliance, if one is used.
• Honor opt-out/unsubscribe requests quickly.
• Allow users to unsubscribe by using the link at the bottom of each email.
If at any time you would like to unsubscribe from receiving future emails, you can email us at
• Follow the instructions at the bottom of each email.
and we will promptly remove you from ALL correspondence.
Any online payment via website is upon acceptance of the followings:
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Consent to Treatment: I recognize that I need medical services. I consent to care at Pacific Cosmetic and Facelift Center by Dr. Valaie, his nurses, aestheticians or assistants. I understand that the practice of medicine is not an exact science and that any treatment and/ or prescribed medication may involve risk and side effects. I understand that I will be informed about the availability of alternate modes of treatment or procedures and their benefits and risks, including no treatment at all, except in emergencies.
Use of Medical Information: I understand consistent with California and federal law, Pacific Cosmetic and Facelift Center and Dr. Valaie will share all medical information as necessary for continuation of care and with any other institution or person as allowed by law. As an example, I understand that Pacific Cosmetic and Facelift Center or Dr. Valaie does not have an in house lab and uses an out-sourced medical laboratory and my lab work and personal information is shared to accomplish testing I may desire. Privacy and confidentiality of personal health information is important at Pacific Cosmetic and Facelift Center and Dr. Valaie. There are policies in place to insure that your personal health information is available only to authorized persons who need access to this information to provide medical care. No patient information leaves this office either electronically, by fax, or paper record without specific authorization by the patient.
Financial Agreement: I acknowledge that I am responsible for all charges for services provided for me, my spouse, and my dependents payable in full on the day that services are rendered. I understand that Pacific Cosmetic and Facelift Center or Dr. Valaie does not file or bill any insurance of any type.
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Our practice is committed to providing you with the latest most advanced technology to help you look and feel your best. We hope to exceed all of your expectations.
Credit Cards: We accept MasterCard and Visa.
Cancellations: We respectfully request 48 hours notice for all cancellations.
Gift Certificates: We offer a variety of gift certificates perfect for any occasion. Our staff would be happy to assist you in selecting a customized gift for any person.
Children: We welcome younger patients to receive treatment when accompanied by an adult. In order to maintain a quiet, relaxing atmosphere, we respectfully ask that children not accompany you to your appointment.
Financial Policies: Your first cosmetic consultation in our facility is complimentary. There is a charge for subsequent consultations and second opinions. The professional fees for each procedure will be discussed individually with you following the consultation. We require payment at the time of service. If you have special circumstances please discuss your needs with our office manager. The surgeon (Dr. Valaie) & surgical products fees are to be paid in full two weeks prior to surgery. Forms of Payment accepted: Cash, Personal Check, Money Order or Cashiers Check and Credit Card (MasterCard, Visa). In order to provide you with the best scheduling options, it is important that we follow the policies listed below.
Scheduling of Surgery: A non-refundable 30% of the surgeon's fee is required to confirm & hold the date of surgery.
Payment of Surgery: The surgeon & surgical products fees are to be paid in full two weeks prior to surgery. Forms of Payment accepted: Cash, Personal Check, Money Order or Cashiers Check and Credit Card (MasterCard, Visa).
No-Refund Policy: All the payments are final and no-refund will be issued under any circumstances. No-refund policy applies to any payments, no-refund policy applies regardless of the desirability of the result. This no-refund policy applies to any sort of treatment, except if Dr. Valaie, determines the patient is not candidate for the paid procedure.
Emergencies: Dr. Valaie is available for the care of the patient's. In a medical emergency, call 911. If you need the services of Dr. Valaie,, call us at:(949) 225-0101 or at his cell phone: (949) 345-1010. .
Rescheduling or Cancellation of Surgery: A $100 fee will be applied to reschedule a confirmed surgery date, greater than 2 weeks before surgery. The fee for cancellation or rescheduling within 2 weeks of surgery is 15% of the surgeon's fee. The fee for cancellation or rescheduling within 48 hours of surgery is 30% of the surgeon's fee.
Additional Surgery: Additional charges will apply if other than the stated procedure(s) is performed or if the procedure takes longer than indicated. Revisions deemed necessary by the physician will be done at a reduced fee.
Our commitment to your privacy: Our practice is dedicated to maintaining the privacy of your health information. We are required by law to maintain the confidentiality of your health information.
We realize that these laws are complicated, but we must provide you with the following important information.
Use and disclosure of your health information in certain special circumstances: The following circumstances may require us to use or disclose your health information:
To public health authorities and health oversight agencies that are authorized by law to collect information. Lawsuits and similar proceedings in response to a court or administrative order. If required to do so by a law enforcement official. When necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. We will only make disclosures to a person or organization able to help the threat. If you are a member or U.S. or foreign military forces (including veterans) and if required by the appropriate authorities. To Federal officials for intelligence and national security activities authorized by law. To correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. For Workers Compensation and similar programs.
Communications: You can request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. We will accommodate reasonable requests.
You can request a restriction in our use or disclosure of your health information for treatment, payment, or health care operations. Additionally, you have the right to request that we restrict our disclosure or your health information to only certain individuals involved in your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.
You have the right to inspect and obtain a copy of the health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660.
You may ask us to amend your health information if you believe it is incorrect or incomplete, and as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660. You must provide us with a reason that supports your request for amendment.
Right to a copy of this notice: You are entitled to receive a copy of this notice of Privacy Practices. You may ask us to give you a copy of this notice at any time. To obtain a copy of this notice, contact Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660.
Right to file a complaint: If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Right to provide an authorization for other uses and disclosures: Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.
If you have any questions regarding this notice or our health information privacy policies, please contact Pacific Cosmetic and Facelift Center or Dr. Valaie at (949) 225-0101.
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Botox Injection Consent:
I understand that I will be injected with Botulinum A Neuromodulator (Botox/Dysport/Xeomin/Jeuveau) in the area of the glabella muscles to paralyze these muscles temporarily or in the forehead or crow’s feet around the lateral area of the eyes or on the nose to address the bunny lines or in the perioral muscles (muscles around the mouth) or in the neck muscles. Botox/Dysport/Xeomin/Jeuveau Neuromodulator (Botox/Dysport/Xeomin/Jeuveau) injection has been FDA approved for use in the cosmetic treatment for glabellar frown lines only (the wrinkles between the eyebrows). The rest of the injection areas are not FDA approved. Injection of Botox/Dysport/Xeomin/Jeuveau into the muscles causes them to halt their function (be paralyzed), thereby improving the appearance of some wrinkles.
I understand the goal is to decrease the wrinkles in the treated area. This paralysis is temporary, and re-injection is necessary within three to four months. It has been explained to me that other temporary and more permanent treatments are available.
The possible side effects of Botox/Dysport/Xeomin/Jeuveau include but are not limited to:
1. Risks: I understand there is a risk of swelling, rash, headache, local numbness, pain at the injection site, bruising, respiratory problems, flu-like symptoms and allergic reaction.
2. Infection: Infections can occur which in most cases are easily treatable but in rare cases a permanent scarring in the area can occur.
3. Most people have slightly swollen pinkish bumps where the injections went in, for a couple of hours or even several days.
4. Although many people with chronic headaches or migraines often get relief from Botox/Dysport/Xeomin/Jeuveau, a small percent of patients get headaches following treatment with Botox/Dysport/Xeomin, for the first day. In a very small percentage of patients these headaches can persist for several days or weeks.
5. Local numbness, rash, pain at the injection site, flu like symptoms with mild fever, back pain. Respiratory problems such as bronchitis or sinusitis, nausea, dizziness, and tightness or irritation of the skin.
6. Bruising is possible anytime you inject a needle into the skin. This bruising can last for several hours, days, weeks, months and in rare cases the effect of bruising could be permanent.
7. While local weakness of the injected muscles is representative of the expected pharmacological action of Botox/Dysport/Xeomin/Jeuveau, weakness of adjacent muscles may occur as a result of the spread of the toxin.
8. Eyebrow or eyelid drop as well as extensive eyebrow elevation are other possibilities.
9. Treatments: I understand more than one injection may be needed to achieve a satisfactory result.
10. Another risk when injecting Botox/Dysport/Xeomin around the eyes included corneal exposure because people may not be able to blink the eyelids as often as they should to protect the eye. This inability to protect the eye has been associated with damage to the eye as impaired vision, or double vision, which is usually temporary. This reduced blinking has been associated with corneal ulcerations. There are medications that can help lift the eyelid, however, if the drooping is too great the eye drops are not that effective. These side effects can last for several weeks or longer. This occurs in 2-5 percent of patients.
11. I will follow all aftercare instructions as it is crucial I do so for healing. As Botox/Dysport/Xeomin/Jeuveau is not an exact science, there might be an uneven appearance of the face with some muscles more affected by the Botox/Dysport/Xeomin/Jeuveau than others.
In most cases this uneven appearance can be corrected by injecting Botox/Dysport/Xeomin/Jeuveau in the same or nearby muscles. However in some cases this uneven appearance can persist for several weeks or months. This list is not meant to be inclusive of all possible risks associated with Botox/Dysport/Xeomin as there are both known and unknown side effects associated with any medication or procedure.
12. Botox/Dysport/Xeomin/Jeuveau should not be administered to a pregnant or nursing woman. You need to notify the practitioner if there is a chance of pregnancy or if you currently nurse your baby.
13. The number of units injected is an estimate of the amount of Botox/Dysport/Xeomin/Jeuveau required to paralyze the muscles. I understand there is no guarantee of results of any treatment. I understand the regular charge applies to all subsequent treatments.
14. I understand and agree that all services rendered to me are charged directly to me and that I am personally responsible for payment. I further agree in the event of non-payment, to bear the cost of collection, and/or Court cost and reasonable legal fees, should this be required. By signing below, I acknowledge that I have read the foregoing informed consent and agree to the treatment with its associated risks. I hereby give consent to perform this and all subsequent Botox/Dysport/Xeomin treatments with the above understood. I hereby release the doctor, the person injecting the Botox/Dysport/Xeomin/Jeuveau and the facility from liability associated with this procedure.
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Dermal Filler Injection Consent:
To the CLIENT: You have a right to be informed about your condition and its treatment, so that you may decide whether or not to undergo the procedure after knowing the risks and hazards involved. This disclosure is not meant to scare or alarm you; it is simply an effort to make you better informed so you may give, or withhold, your consent for treatment.
1. I understand that I will be injected with Dermal Filler in the facial area. Dermal Fillers injections are implanted intradermally or subdermally through a fine gauge needle into the treated area.
2. All the dermal filler that Dr. Valaie uses have been FDA approved for use in cosmetic treatments of moderate to severe facial wrinkles. However their specific use in the specific type of wrinkles or place of use is NOT necessarily FDA approved.
3. I understand that multiple treatments are necessary to achieve desired results. Treatments generally last six months to two years. Touch up treatments may be necessary to maintain desired results. No guarantee, warranty, or assurance has been made to me as to the results that may be obtained. Clinical results will vary per patient. I agree to adhere to all safety precautions and regulations during the treatment. No refunds will be given for treatments received.
4. Possible Side Effects can include but are not limited to: Allergic reaction or infection, poor cosmetic result, bleeding, tenderness or pain, redness, bruising, scarring, sensory problem, temporary or long term paralysis of the muscles, dark spots, lumps and bumps, Keloid formation/hypertrophic scarring or swelling at injection site, acneiform eruptions, lumps, inflammatory nodules, blue bumps (i.e., the Tyndall effect), vascular occlusion (occlusion of vasculature of eyes, different face elements, skin, etc), which can result in permanent damage of the organ. Inflammatory papules (red or swollen bumps) as well as blindness have also been reported after blockage of vessels by the dermal fillers.
5. I am aware that a topical or local anesthetic may be used by Dr. Valaie to alleviate pain and discomfort. I will advise him if I have any allergies of any sort.
6. I understand if I have a history of Keloid formation or hypertrophic scarring I must advise my physician and I am aware that I will not be eligible for this treatment.
7. If I currently take any blood thinners such as ibuprofen, aspirin, or herbal preparations prior to my procedure I will advise Dr. Valaie. I understand the use of these medications may increase my risk of bruising.
8. I understand that Dermal Fillers will not correct the underlying cause of facial fat loss but will improve the appearance in the treated area.
9. I have advised Dr. Valaie, if I have a history of cold sores/fever blisters or if I have a history of allergies to microorganisms known as gram positive bacteria, to drugs that require in-hospital treatment, or if I have a bleeding disorder.
10. I have read and understand the Pre and Post-Treatment Instructions. I agree to follow these instructions carefully. I understand that compliance with recommended pre and post procedure guidelines are crucial for healing, prevention of side effects and complications as listed above.
11. I understand and agree that all services rendered to me are charged to me directly and that I am personally responsible for payment regardless of my satisfaction level. Also I understand that there will not be any refund after the injection.
12. I am not pregnant or trying to become pregnant nor am I nursing at this time.
The nature and purpose of the treatment have been explained to me. I have read and understand this agreement. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. Alternative methods of treatment and their risks and benefits have been explained to me and I understand that I have the right to refuse treatment.
13. I agree, if I should I have any questions or concerns regarding my treatment / results I will notify this office at (949) 225 0101, and/or Dr. Valaie’s Cell # (949) 345-1010 immediately so that timely follow-up and intervention can be provided.
I am aware that I need to contact Dr. Valaie directly in case of bruising, discolorations and pain.
I released Pacific Cosmetic and Facelift Center, medical staff, and Dr. Valaie from liability associated with the procedure. I certify that I am a competent adult of at least 18 years of age. This consent form is freely and voluntarily executed and shall be binding upon my spouse, relatives, legal representatives, heirs, administrators, successors and assigns.
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Assumption of the Risk and Waiver of Liability Relating to
Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Paicific Cosmetic and Facelift Center, Dr. Valaie, MD and their staff ("Office"), have put in place preventative measures to reduce the spread of COVID-19; however, the Office cannot guarantee that you will not become infected with COVID-19. Further, your presence in Office location could increase your risk and possibly your family’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I and consecuentially my family and closed contacts may be exposed to or infected by COVID-19 by presenting in the Office location and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Office location may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Office and Office employees, volunteers, and program participants and other present patients or people.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself, my family members and my close contacts (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my family members or my close contacts may experience or incur in connection with my attendance at the Office ("Claims"). On my behalf, and on behalf of my family and closed people, I hereby release, covenant not to sue, discharge, and hold harmless the Office, its employees, agents, physicians, nurses, pateint coordinators, front desk employees, staff and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Office, its employees, agents, physicians, nurses, pateint coordinators, front desk employees, staff and representatives, whether a COVID-19 infection occurs before, during, or after my presence in the Office location.
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Photography Consent:
I consent for medical photographs to be made of me. I understand that the information may be used in my medical record, for purposes of assessment of my treatment’s results.
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Contacting Us
If there are any questions regarding this privacy policy, you may contact us using the information below.
drvalaie.com
1601 Dove St. #125
Newport Beach, California 92660
United States
(949) 225-0101
This privacy policy has been compiled to better serve those who are concerned with how their 'Personally Identifiable Information' (PII) is being used online. PII, as described in US privacy law and information security, is information that can be used on its own or with other information to identify, contact, or locate a single person, or to identify an individual in context. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website.
What personal information do we collect from the people that visit our blog, website or app?
When ordering or registering on our site, as appropriate, you may be asked to enter your name, email address, phone number or other details to help you with your experience.
When do we collect information?
We collect information from you when you register on our site or enter information through our forms on our site.
How do we use your information?
We may use the information we collect from you when you register, make a purchase, sign up for our newsletter, respond to a survey or marketing communication, filling out forms, surf the website, or use certain other site features in the following ways:
• To administer a contest, promotion, survey or other site feature.
• To ask for ratings and reviews of services or products
• To follow up with them after correspondence (live chat, email or phone inquiries)
Also we use the information from filling out our forms to email your our promotions on a weekly or biweekly matter.
You get to unsubscribe at anytime.
Each promotional email will have unsubscribe link in it.
How do we protect your information?
We do not use vulnerability scanning and/or scanning to PCI standards.
We only provide articles and information. We never ask for credit card numbers.
We do not use Malware Scanning.
Your personal information is contained behind secured networks and is only accessible by a limited number of persons who have special access rights to such systems, and are required to keep the information confidential. In addition, all sensitive/credit information you supply is encrypted via Secure Socket Layer (SSL) technology.
We only collect
We implement a variety of security measures when a user enters, submits, or accesses their information to maintain the safety of your personal information.
All transactions are processed through a gateway provider and are not stored or processed on our servers.
Do we use 'cookies'?
We do not use cookies for tracking purposes
You can choose to have your computer warn you each time a cookie is being sent, or you can choose to turn off all cookies. You do this through your browser settings. Since browser is a little different, look at your browser's Help Menu to learn the correct way to modify your cookies.
If you turn cookies off, Some of the features that make your site experience more efficient may not function properly.that make your site experience more efficient and may not function properly.
Third-party disclosure
We do not sell, trade, or otherwise transfer to outside parties your Personally Identifiable Information.
Third-party links
We do not include or offer third-party products or services on our website.
Google's advertising requirements can be summed up by Google's Advertising Principles. They are put in place to provide a positive experience for users. https://support.google.com/adwordspolicy/answer/1316548?hl=en
We have not enabled Google AdSense on our site but we may do so in the future.
California Online Privacy Protection Act
CalOPPA is the first state law in the nation to require commercial websites and online services to post a privacy policy. The law's reach stretches well beyond California to require any person or company in the United States (and conceivably the world) that operates websites collecting Personally Identifiable Information from California consumers to post a conspicuous privacy policy on its website stating exactly the information being collected and those individuals or companies with whom it is being shared. - See more at: http://consumercal.org/california-online-privacy-protection-act-caloppa/#sthash.0FdRbT51.dpuf
According to CalOPPA, we agree to the following:
Users can visit our site anonymously.
Once this privacy policy is created, we will add a link to it on our home page or as a minimum, on the first significant page after entering our website.
Our Privacy Policy link includes the word 'Privacy' and can easily be found on the page specified above.
You will be notified of any Privacy Policy changes:
• On our Privacy Policy Page
Can change your personal information:
• By emailing us
• By calling us
How does our site handle Do Not Track signals?
We honor Do Not Track signals and Do Not Track, plant cookies, or use advertising when a Do Not Track (DNT) browser mechanism is in place.
Does our site allow third-party behavioral tracking?
It's also important to note that we do not allow third-party behavioral tracking
COPPA (Children Online Privacy Protection Act)
When it comes to the collection of personal information from children under the age of 13 years old, the Children's Online Privacy Protection Act (COPPA) puts parents in control. The Federal Trade Commission, United States' consumer protection agency, enforces the COPPA Rule, which spells out what operators of websites and online services must do to protect children's privacy and safety online.
We do not specifically market to children under the age of 13 years old.
Fair Information Practices
The Fair Information Practices Principles form the backbone of privacy law in the United States and the concepts they include have played a significant role in the development of data protection laws around the globe. Understanding the Fair Information Practice Principles and how they should be implemented is critical to comply with the various privacy laws that protect personal information.
In order to be in line with Fair Information Practices we will take the following responsive action, should a data breach occur:
We will notify you via email
• Within 7 business days
We also agree to the Individual Redress Principle which requires that individuals have the right to legally pursue enforceable rights against data collectors and processors who fail to adhere to the law. This principle requires not only that individuals have enforceable rights against data users, but also that individuals have recourse to courts or government agencies to investigate and/or prosecute non-compliance by data processors.
CAN SPAM Act
The CAN-SPAM Act is a law that sets the rules for commercial email, establishes requirements for commercial messages, gives recipients the right to have emails stopped from being sent to them, and spells out tough penalties for violations.
We collect your email address in order to:
• Send information, respond to inquiries, and/or other requests or questions
To be in accordance with CANSPAM, we agree to the following:
• Not use false or misleading subjects or email addresses.
• Include the physical address of our business or site headquarters.
• Monitor third-party email marketing services for compliance, if one is used.
• Honor opt-out/unsubscribe requests quickly.
• Allow users to unsubscribe by using the link at the bottom of each email.
If at any time you would like to unsubscribe from receiving future emails, you can email us at
• Follow the instructions at the bottom of each email.
and we will promptly remove you from ALL correspondence.
Any online payment via website is upon acceptance of the followings:
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Consent to Treatment: I recognize that I need medical services. I consent to care at Pacific Cosmetic and Facelift Center by Dr. Valaie, his nurses, aestheticians or assistants. I understand that the practice of medicine is not an exact science and that any treatment and/ or prescribed medication may involve risk and side effects. I understand that I will be informed about the availability of alternate modes of treatment or procedures and their benefits and risks, including no treatment at all, except in emergencies.
Use of Medical Information: I understand consistent with California and federal law, Pacific Cosmetic and Facelift Center and Dr. Valaie will share all medical information as necessary for continuation of care and with any other institution or person as allowed by law. As an example, I understand that Pacific Cosmetic and Facelift Center or Dr. Valaie does not have an in house lab and uses an out-sourced medical laboratory and my lab work and personal information is shared to accomplish testing I may desire. Privacy and confidentiality of personal health information is important at Pacific Cosmetic and Facelift Center and Dr. Valaie. There are policies in place to insure that your personal health information is available only to authorized persons who need access to this information to provide medical care. No patient information leaves this office either electronically, by fax, or paper record without specific authorization by the patient.
Financial Agreement: I acknowledge that I am responsible for all charges for services provided for me, my spouse, and my dependents payable in full on the day that services are rendered. I understand that Pacific Cosmetic and Facelift Center or Dr. Valaie does not file or bill any insurance of any type.
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Our practice is committed to providing you with the latest most advanced technology to help you look and feel your best. We hope to exceed all of your expectations.
Credit Cards: We accept MasterCard and Visa.
Cancellations: We respectfully request 48 hours notice for all cancellations.
Gift Certificates: We offer a variety of gift certificates perfect for any occasion. Our staff would be happy to assist you in selecting a customized gift for any person.
Children: We welcome younger patients to receive treatment when accompanied by an adult. In order to maintain a quiet, relaxing atmosphere, we respectfully ask that children not accompany you to your appointment.
Financial Policies: Your first cosmetic consultation in our facility is complimentary. There is a charge for subsequent consultations and second opinions. The professional fees for each procedure will be discussed individually with you following the consultation. We require payment at the time of service. If you have special circumstances please discuss your needs with our office manager. The surgeon (Dr. Valaie) & surgical products fees are to be paid in full two weeks prior to surgery. Forms of Payment accepted: Cash, Personal Check, Money Order or Cashiers Check and Credit Card (MasterCard, Visa). In order to provide you with the best scheduling options, it is important that we follow the policies listed below.
Scheduling of Surgery: A non-refundable 30% of the surgeon's fee is required to confirm & hold the date of surgery.
Payment of Surgery: The surgeon & surgical products fees are to be paid in full two weeks prior to surgery. Forms of Payment accepted: Cash, Personal Check, Money Order or Cashiers Check and Credit Card (MasterCard, Visa).
No-Refund Policy: All the payments are final and no-refund will be issued under any circumstances. No-refund policy applies to any payments, no-refund policy applies regardless of the desirability of the result. This no-refund policy applies to any sort of treatment, except if Dr. Valaie, determines the patient is not candidate for the paid procedure.
Emergencies: Dr. Valaie is available for the care of the patient's. In a medical emergency, call 911. If you need the services of Dr. Valaie,, call us at:(949) 225-0101 or at his cell phone: (949) 345-1010. .
Rescheduling or Cancellation of Surgery: A $100 fee will be applied to reschedule a confirmed surgery date, greater than 2 weeks before surgery. The fee for cancellation or rescheduling within 2 weeks of surgery is 15% of the surgeon's fee. The fee for cancellation or rescheduling within 48 hours of surgery is 30% of the surgeon's fee.
Additional Surgery: Additional charges will apply if other than the stated procedure(s) is performed or if the procedure takes longer than indicated. Revisions deemed necessary by the physician will be done at a reduced fee.
Our commitment to your privacy: Our practice is dedicated to maintaining the privacy of your health information. We are required by law to maintain the confidentiality of your health information.
We realize that these laws are complicated, but we must provide you with the following important information.
Use and disclosure of your health information in certain special circumstances: The following circumstances may require us to use or disclose your health information:
To public health authorities and health oversight agencies that are authorized by law to collect information. Lawsuits and similar proceedings in response to a court or administrative order. If required to do so by a law enforcement official. When necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. We will only make disclosures to a person or organization able to help the threat. If you are a member or U.S. or foreign military forces (including veterans) and if required by the appropriate authorities. To Federal officials for intelligence and national security activities authorized by law. To correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. For Workers Compensation and similar programs.
Communications: You can request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. We will accommodate reasonable requests.
You can request a restriction in our use or disclosure of your health information for treatment, payment, or health care operations. Additionally, you have the right to request that we restrict our disclosure or your health information to only certain individuals involved in your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.
You have the right to inspect and obtain a copy of the health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660.
You may ask us to amend your health information if you believe it is incorrect or incomplete, and as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660. You must provide us with a reason that supports your request for amendment.
Right to a copy of this notice: You are entitled to receive a copy of this notice of Privacy Practices. You may ask us to give you a copy of this notice at any time. To obtain a copy of this notice, contact Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660.
Right to file a complaint: If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact Pacific Cosmetic and Facelift Center or Dr. Valaie, 1601 Dove St. #125, Newport Beach, CA 92660. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Right to provide an authorization for other uses and disclosures: Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.
If you have any questions regarding this notice or our health information privacy policies, please contact Pacific Cosmetic and Facelift Center or Dr. Valaie at (949) 225-0101.
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Botox Injection Consent:
I understand that I will be injected with Botulinum A Neuromodulator (Botox/Dysport/Xeomin/Jeuveau) in the area of the glabella muscles to paralyze these muscles temporarily or in the forehead or crow’s feet around the lateral area of the eyes or on the nose to address the bunny lines or in the perioral muscles (muscles around the mouth) or in the neck muscles. Botox/Dysport/Xeomin/Jeuveau Neuromodulator (Botox/Dysport/Xeomin/Jeuveau) injection has been FDA approved for use in the cosmetic treatment for glabellar frown lines only (the wrinkles between the eyebrows). The rest of the injection areas are not FDA approved. Injection of Botox/Dysport/Xeomin/Jeuveau into the muscles causes them to halt their function (be paralyzed), thereby improving the appearance of some wrinkles.
I understand the goal is to decrease the wrinkles in the treated area. This paralysis is temporary, and re-injection is necessary within three to four months. It has been explained to me that other temporary and more permanent treatments are available.
The possible side effects of Botox/Dysport/Xeomin/Jeuveau include but are not limited to:
1. Risks: I understand there is a risk of swelling, rash, headache, local numbness, pain at the injection site, bruising, respiratory problems, flu-like symptoms and allergic reaction.
2. Infection: Infections can occur which in most cases are easily treatable but in rare cases a permanent scarring in the area can occur.
3. Most people have slightly swollen pinkish bumps where the injections went in, for a couple of hours or even several days.
4. Although many people with chronic headaches or migraines often get relief from Botox/Dysport/Xeomin/Jeuveau, a small percent of patients get headaches following treatment with Botox/Dysport/Xeomin, for the first day. In a very small percentage of patients these headaches can persist for several days or weeks.
5. Local numbness, rash, pain at the injection site, flu like symptoms with mild fever, back pain. Respiratory problems such as bronchitis or sinusitis, nausea, dizziness, and tightness or irritation of the skin.
6. Bruising is possible anytime you inject a needle into the skin. This bruising can last for several hours, days, weeks, months and in rare cases the effect of bruising could be permanent.
7. While local weakness of the injected muscles is representative of the expected pharmacological action of Botox/Dysport/Xeomin/Jeuveau, weakness of adjacent muscles may occur as a result of the spread of the toxin.
8. Eyebrow or eyelid drop as well as extensive eyebrow elevation are other possibilities.
9. Treatments: I understand more than one injection may be needed to achieve a satisfactory result.
10. Another risk when injecting Botox/Dysport/Xeomin around the eyes included corneal exposure because people may not be able to blink the eyelids as often as they should to protect the eye. This inability to protect the eye has been associated with damage to the eye as impaired vision, or double vision, which is usually temporary. This reduced blinking has been associated with corneal ulcerations. There are medications that can help lift the eyelid, however, if the drooping is too great the eye drops are not that effective. These side effects can last for several weeks or longer. This occurs in 2-5 percent of patients.
11. I will follow all aftercare instructions as it is crucial I do so for healing. As Botox/Dysport/Xeomin/Jeuveau is not an exact science, there might be an uneven appearance of the face with some muscles more affected by the Botox/Dysport/Xeomin/Jeuveau than others.
In most cases this uneven appearance can be corrected by injecting Botox/Dysport/Xeomin/Jeuveau in the same or nearby muscles. However in some cases this uneven appearance can persist for several weeks or months. This list is not meant to be inclusive of all possible risks associated with Botox/Dysport/Xeomin as there are both known and unknown side effects associated with any medication or procedure.
12. Botox/Dysport/Xeomin/Jeuveau should not be administered to a pregnant or nursing woman. You need to notify the practitioner if there is a chance of pregnancy or if you currently nurse your baby.
13. The number of units injected is an estimate of the amount of Botox/Dysport/Xeomin/Jeuveau required to paralyze the muscles. I understand there is no guarantee of results of any treatment. I understand the regular charge applies to all subsequent treatments.
14. I understand and agree that all services rendered to me are charged directly to me and that I am personally responsible for payment. I further agree in the event of non-payment, to bear the cost of collection, and/or Court cost and reasonable legal fees, should this be required. By signing below, I acknowledge that I have read the foregoing informed consent and agree to the treatment with its associated risks. I hereby give consent to perform this and all subsequent Botox/Dysport/Xeomin treatments with the above understood. I hereby release the doctor, the person injecting the Botox/Dysport/Xeomin/Jeuveau and the facility from liability associated with this procedure.
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Dermal Filler Injection Consent:
To the CLIENT: You have a right to be informed about your condition and its treatment, so that you may decide whether or not to undergo the procedure after knowing the risks and hazards involved. This disclosure is not meant to scare or alarm you; it is simply an effort to make you better informed so you may give, or withhold, your consent for treatment.
1. I understand that I will be injected with Dermal Filler in the facial area. Dermal Fillers injections are implanted intradermally or subdermally through a fine gauge needle into the treated area.
2. All the dermal filler that Dr. Valaie uses have been FDA approved for use in cosmetic treatments of moderate to severe facial wrinkles. However their specific use in the specific type of wrinkles or place of use is NOT necessarily FDA approved.
3. I understand that multiple treatments are necessary to achieve desired results. Treatments generally last six months to two years. Touch up treatments may be necessary to maintain desired results. No guarantee, warranty, or assurance has been made to me as to the results that may be obtained. Clinical results will vary per patient. I agree to adhere to all safety precautions and regulations during the treatment. No refunds will be given for treatments received.
4. Possible Side Effects can include but are not limited to: Allergic reaction or infection, poor cosmetic result, bleeding, tenderness or pain, redness, bruising, scarring, sensory problem, temporary or long term paralysis of the muscles, dark spots, lumps and bumps, Keloid formation/hypertrophic scarring or swelling at injection site, acneiform eruptions, lumps, inflammatory nodules, blue bumps (i.e., the Tyndall effect), vascular occlusion (occlusion of vasculature of eyes, different face elements, skin, etc), which can result in permanent damage of the organ. Inflammatory papules (red or swollen bumps) as well as blindness have also been reported after blockage of vessels by the dermal fillers.
5. I am aware that a topical or local anesthetic may be used by Dr. Valaie to alleviate pain and discomfort. I will advise him if I have any allergies of any sort.
6. I understand if I have a history of Keloid formation or hypertrophic scarring I must advise my physician and I am aware that I will not be eligible for this treatment.
7. If I currently take any blood thinners such as ibuprofen, aspirin, or herbal preparations prior to my procedure I will advise Dr. Valaie. I understand the use of these medications may increase my risk of bruising.
8. I understand that Dermal Fillers will not correct the underlying cause of facial fat loss but will improve the appearance in the treated area.
9. I have advised Dr. Valaie, if I have a history of cold sores/fever blisters or if I have a history of allergies to microorganisms known as gram positive bacteria, to drugs that require in-hospital treatment, or if I have a bleeding disorder.
10. I have read and understand the Pre and Post-Treatment Instructions. I agree to follow these instructions carefully. I understand that compliance with recommended pre and post procedure guidelines are crucial for healing, prevention of side effects and complications as listed above.
11. I understand and agree that all services rendered to me are charged to me directly and that I am personally responsible for payment regardless of my satisfaction level. Also I understand that there will not be any refund after the injection.
12. I am not pregnant or trying to become pregnant nor am I nursing at this time.
The nature and purpose of the treatment have been explained to me. I have read and understand this agreement. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. Alternative methods of treatment and their risks and benefits have been explained to me and I understand that I have the right to refuse treatment.
13. I agree, if I should I have any questions or concerns regarding my treatment / results I will notify this office at (949) 225 0101, and/or Dr. Valaie’s Cell # (949) 345-1010 immediately so that timely follow-up and intervention can be provided.
I am aware that I need to contact Dr. Valaie directly in case of bruising, discolorations and pain.
I released Pacific Cosmetic and Facelift Center, medical staff, and Dr. Valaie from liability associated with the procedure. I certify that I am a competent adult of at least 18 years of age. This consent form is freely and voluntarily executed and shall be binding upon my spouse, relatives, legal representatives, heirs, administrators, successors and assigns.
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Assumption of the Risk and Waiver of Liability Relating to
Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Paicific Cosmetic and Facelift Center, Dr. Valaie, MD and their staff ("Office"), have put in place preventative measures to reduce the spread of COVID-19; however, the Office cannot guarantee that you will not become infected with COVID-19. Further, your presence in Office location could increase your risk and possibly your family’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I and consecuentially my family and closed contacts may be exposed to or infected by COVID-19 by presenting in the Office location and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Office location may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Office and Office employees, volunteers, and program participants and other present patients or people.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself, my family members and my close contacts (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my family members or my close contacts may experience or incur in connection with my attendance at the Office ("Claims"). On my behalf, and on behalf of my family and closed people, I hereby release, covenant not to sue, discharge, and hold harmless the Office, its employees, agents, physicians, nurses, pateint coordinators, front desk employees, staff and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Office, its employees, agents, physicians, nurses, pateint coordinators, front desk employees, staff and representatives, whether a COVID-19 infection occurs before, during, or after my presence in the Office location.
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Photography Consent:
I consent for medical photographs to be made of me. I understand that the information may be used in my medical record, for purposes of assessment of my treatment’s results.
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Contacting Us
If there are any questions regarding this privacy policy, you may contact us using the information below.
drvalaie.com
1601 Dove St. #125
Newport Beach, California 92660
United States
(949) 225-0101