CANCELLATION POLICY

We make every effort to schedule our patients with the appropriate amount of time for their treatment and to see them on time. We expect the same effort from our patients in making their scheduled appointments.

Policy requires that our patients provide at least 24 hours notice when needing to cancel an appointment. Failure to provide such notice may result in a $35 “cancellation” fee.

Although rarely an issue... patients that do not show for three consecutive appointments may be discharged from the practice.

I HAVE READ AND UNDERSTAND THIS CANCELLATION POLICY

 

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Name

 

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Date