Patient Cancellation Policy

Please complete this form to demonstrate your understanding of our cancellation policies. Thank you!

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We understand that sometimes, a patient cannot make a scheduled appointment due to unforeseen circumstances. However, we require patients to reschedule or cancel appointments within 24 hours of a scheduled visit. If you are a no-show or fail to reschedule/cancel an appointment without giving the 24-hour notice, a $75.00 charge will be billed to you. We are sure you are aware that missing an appointment prevents us from giving you the care you need. However, it is also detrimental to us because it prevents us from scheduling another patient who also needs care.