Enroll in Our Royalty Program Today

Pamper yourself each month

Use the form below to sign up for our Royalty Program today and enjoy one service each month, plus a 20% discount on product purchases, early access to special events and more! This program is a $200 monthly subscription that will automatically renew.

Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Payment Authorization*
By checking here, I authorize the a monthly recurring payment to charge my account using the information I enter on the next page.
Your consent authorizes St. Charles County Dermatologic Surgery to charge your account on the first or fifteenth day of each month for the amount of $200. This charge will automatically take place as long as you are enrolled in the Royalty Program. You may cancel at any time after 6 months of enrollment. If you cancel before 6 months, you will be charged a $300 early termination fee.
When would you like to be billed for your subsciption?*
- The first day of the month
- The fifteenth day of the month

STEP 2: Payment

After you select "Submit" above, you will need to complete your payment by selecting the link below. Please enter $200 in the Payment Amount section: Complete Your Payment and Finalize Registration ›

Terms and Conditions

Your registration and consent will authorize St. Charles County Dermatologic Surgery to charge your account $200 each month for your subscription. Your subscription will automatically credit any unused services to the next month. You may roll over for up to four months of credit each year (up to $1000).

You may cancel your subscription by emailing info@SCCDermSurgery.com or calling 636-317-DERM (3376).

Enroll in Our Royalty Program Today

Pamper yourself each month

STEP 2: Payment

Contact Us

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