APPOINTMENT AGREEMENT

  • APPOINTMENT AGREEMENT

    We schedule our dental appointments very carefully to assure that sufficient time is allowed for every procedure. When we are not notified, a missed appointment means that another patient who could have been seen was not. This also adds to the overall cost of care, as trained personnel and dental facilities are not being used. We certainly understand that occasionally circumstances arise that prevents patients from keeping appointments. It happens to the best of us! If in the future you are unable to keep your appointment please be so kind as to notify us at least 24 hours prior to your appointment time. With this prior notice, we can reschedule your appointment and let another patient receive treatment during the time originally reserved for you. If we are not notified in advance of a cancellation or you do not show for your appointment we will have no other alternative but to charge your account a fee as follows:
    Less than 24 hours notice $75.00
    No Show $100.00

    Thank you in advance for your cooperation. Having understanding, courteous patients enables us to better serve the needs of all our patients. I have read and understand the above agreement.