Please understand that our appointment times are scheduled to allow us to take care of each individual patient’s needs during the patient’s visit. Since appointments are in high demand, we value advance notice from our patients who are unable to keep their scheduled appointments.
In an effort to decrease unnecessary costs and to contain our fees, we maintain a No Show/Cancellations Policy for our patients. To promote efficient access to our clinic, we require that any appointment that is no longer needed or unable to be kept must be cancelled more than 24 hours in advance. Cancellations must be made between 8 am and 5 pm on workdays at least one full business day before the scheduled appointment. Cancellations must be done over the telephone by speaking directly to one of our scheduling professionals. Patients will not be charged for an office visit if cancellation is made 24 business hours before their appointment.
In the event, an appointment is missed or cancelled with less than 24 hours notice or no notice, a $75 charge will be billed. If a second no-show or same-day cancellation occurs, we reserve the right to terminate the patient-doctor relationship.
This policy is in effect for all appointments at our office. Again, all no-shows or same-day cancellations will be invoiced $75 if not cancelled with a 24 business hour notification.
Finally, you acknowledge that you have had an opportunity to review this agreement with the counsel of your choosing. This agreement shall be valid and enforceable from this day forward.
My signature below indicates that I have read and understand these policies.