Patient Forms - Kids

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No Show / Late Arrival Policy

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In an effort to maximize the time your physician spends with you and minimize your wait time, we have made changes to our No-Show and Late Arrival Policies as follows:

NO SHOW POLICY

Effective October 15, 2014, we will implement a “no-show” policy which will affect all patients who do not keep their scheduled appointment or who cancel an appointment with less than a 24-hour notice.

First occurrence – Patient/parent will receive a phone call advising of our policy and offering to reschedule the missed appointment.

Second occurrence – Patient/parent will receive a formal letter and may be subject to a $25.00 no show fee.

Third and subsequent occurrences – May result in dismissal from practice and additional $25.00 no show fee for each occurrence.

LATE ARRIVAL POLICY

Any patient arriving late for their appointment may be subject to reschedule or cancellation.