Your oral hygiene is important to us and we strive to provide excellent dental care to you, as well as all of our patients. In order for us to keep this level of service, we have a Cancellation and Failed Appointment Policy that allows us to schedule appointments for all patients. When we make your appointment, we are reserving a room for your particular needs. We ask that if you must charge an appointment, please give us at least 24 hours' notice. This courtesy makes it possible to give your reserved room to another patient who would like it.
Our policy is as follows:
For regular appointments, we require at least 24 hours notice for any appointment changes or cancellations.
For appointments 90 minutes and longer (such as for crowns, bridges or scaling and root planning), we require at least 48 hours notice for any appointment changes or cancellations.
Three late cancellations or failed appointments (or the combination of) may result in a dismissal from our practice. We understand that situations may arise which prevent proper notification for missing an appointment, so we will review each account for evidence of abuse of the cancellation policy.
This policy allows for other patients to be scheduled into the appointment time you cannot make. If you miss an appointment without contacting our office within the required time, this is considered a missed appointment. A fee of $50.00 will be charged to you; this fee cannot be billed to your insurance company and will be your direct responsibility. No future appointments can be scheduled nor can records be transferred without the payment if this fee.
If you have any questions regarding this policy, please let our office know and we will be glad to clarify any questions you have.
We thank you for trusting us with your dental care.
I have read and understand the Cancellation and Failed Appointment Policy of the practice and I agree to be bound by its terms. I also understand and agree that such terms be amended from time-to-time by the practice.