7789 Southwest Fwy, Suite 400, Houston, TX 77074 I (832) 649-4273

Cancellation and Office Policies

Please read the entire policy before signing

As a courtesy to other patients and appointment availability, we require a 24-Hour notice to cancel or re-schedule your appointments. We will charge a $30.00 fee for failure to Cancel/Re- Schedule or No-Show. You may cancel the appointment by using your patient portal, calling the office during business hours, or leaving a voicemail after business hours. This fee will be charged to you and MUST be paid prior to your next appointment. We understand that emergencies do arise, and we will handle it on a case-by-case basis.

We will allow a 15min window from your scheduled appointment time. If you are running late or taking longer than normal to provide necessary paperwork, you will have to re-schedule your appointment. Please give us a call if you are running late; however, your appointment may be

Co-Pays, Deductibles, and any fees for your Office or Surgical procedures are due at the time of service, we do not bill patients.

For FMLA or Short-Term Disability forms, there will be a fee of $25.00 for completion. The process can take 5-7 business days, please provide your paperwork in timely matter. For expedited processing, it will be $35.00.

We will be charging a $150.00 fee for surgery cancellations once your surgery has been scheduled and orders are complete. If you have already paid a surgery deposit, it will be deducted from there. Fee must be paid prior to re-scheduling surgery.

I have read and understood the above office policies and I am aware that I am responsible for any fees that are charged to me.