Patient Appointment Agreement Sample Contracts

Patient Appointment Agreement
Patient Appointment Agreement • May 5th, 2020

Welcome and thank you for choosing the East Carolina University School of Dental Medicine for your oral health care needs. We are committed to providing you with the best possible service and appreciate the trust you have placed in our team of professionals. It is important for you to understand and agree to the following information so as to avoid any misunderstanding about our appointment policies.

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PATIENT APPOINTMENT AGREEMENT
Patient Appointment Agreement • May 13th, 2020

We truly appreciate your courtesy of giving us 48 hours’ notice if you have a conflict with your appointment and need to schedule a different day or time. We are committed to your oral health and keeping your scheduled appointments allows us to be partners in your dental care.

Locust Family Dentistry Patient Appointment Agreement
Patient Appointment Agreement • May 19th, 2017

Welcome and thank you for choosing Locust Family Dentistry for your oral healthcare needs. We are committed to providing you with the best possible service and appreciate the trust you have placed in our team of professionals.

MyCare Patient Appointment Agreement
Patient Appointment Agreement • February 20th, 2020

We value you as our patient and need your cooperation with keeping appointments so that we can provide your care in a timely, high quality manner. We often have more patients who need care than we have room in our daily schedule to accommodate. When a patient does not show up or cancels an appointment too close to his or her scheduled time, we are unable to fill this appointment time with another patient who desperately needs care. If a patient is late for a scheduled appointment, it causes our days to run late and impacts all of our patients. This policy ensures that both you and our other patients receive the care that you need.

Patient Appointment Agreement for Audiology Services
Patient Appointment Agreement • October 14th, 2020

Due to the personnel resources and time commitment needed to provide the complex services offered, it is imperative that our patients be very faithful in keeping their scheduled appointments. We understand that unforeseen events occur that require last minute cancellations of appointments. However, Dallas Ear Institute cannot be expected to bear the financial loss that occurs when this reserved appointment time goes unutilized.

Your Agreement with us:
Patient Appointment Agreement • June 6th, 2020

If a face to face appointment has been booked for you at either our Ashbourne or Hilton Physio Centres, a Therapist will have discussed with you why they feel a face to face appointment is appropriate in your case and by booking this appointment you are agreeing to attend and consent to the assessment and treatment planned. If you still have any concerns that have not been answered please speak to us prior to the appointment.

PATIENT APPOINTMENT AGREEMENT ARTHUR JENKINS, DDS
Patient Appointment Agreement • July 22nd, 2015

We truly appreciate your courtesy of giving us two (2) business days’ notice if you have a conflict with your appointment and need to schedule a different day or time. We are committed to your oral health and keeping your scheduled appointments allows us to be partners in your dental care.

PATIENT APPOINTMENT AGREEMENT FOR LAURIE MULKA, DDS
Patient Appointment Agreement • February 26th, 2014

• I acknowledge after 2 appointments in which I do not provide 48 hours notice, I may be required to leave a $50 deposit in order to schedule my next appointment

Patient Appointment Agreement
Patient Appointment Agreement • August 28th, 2020

The staff at Edisto Dental Associates is committed to providing our patients with the best care possible. Your clear understanding of our appointment agreement is important to the success of our relationship with you. We are happy to discuss this agreement with you at any time.

Patient Appointment Agreement
Patient Appointment Agreement • March 27th, 2015

The staff at Edisto Dental Associates is committed to providing our patients with the best care possible. Your clear understanding of our appointment agreement is important to the success of our relationship with you. We are happy to discuss this agreement with you at any time.

PATIENT APPOINTMENT AGREEMENT
Patient Appointment Agreement • April 14th, 2023

Our practice is committed to providing optimal care while valuing every patient's time and providing as many opportunities for appointments as possible within the week. We know that exceptional patient experience encompasses quality of care as well as timely service.

PATIENT APPOINTMENT AGREEMENT
Patient Appointment Agreement • August 9th, 2016

We truly appreciate your courtesy of giving us 48 hours notice if you have a conflict with your appointment and need to schedule a different day or time. We are committed to your oral health and keeping your scheduled appointments allows us to be partners in your dental care.

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