Common Contracts
1 similar Patient Financial Agreement contracts
Patient Financial AgreementPatient Financial Agreement • May 8th, 2015
No Call/NoShow Policy: We make every effort to provide prompt care to all of our patients. If you are unable to keep a scheduled appointment, please notify our office 24 to 48 hours in advance. We will reschedule a No Call/No Show appointment once. A second No Show will generate a $30.00 fee, which must be paid in advance before we re- schedule a third appt. In the event that you have a special circumstance regarding your missed appointment, please contact our office manager. We understand that there may be issues beyond your control. If you are delayed and cannot make an appointment on time, please call to advise us of your situation and provide an estimated time of arrival. Any delay, of 15 min. or more may require the visit to be rescheduled at our discretion.
