HIPAA & Office Policies

APPOINTMENT CANCELLATION POLICY

We understand that unplanned issues can come up and you may need to cancel an appointment. If that happens, we respectfully ask for scheduled appointments to be canceled at least 48 hours in advance.

Our doctors and hygienists want to be available for your needs and the needs of all our patients. When a patient does not show up for an appointment, another patient loses an opportunity to be seen. The policy is as follows:

Failure to notify the office of a canceled appointment within the aforementioned time frame will result in a $75 penalty fee for every hour scheduled.

Thank you for being a valued patient and for your understanding and cooperation as we reinforce this policy. This policy will enable us to frame our schedule to best serve all our patients.

HIPAA CONSENT

By signing below, I acknowledge that I have read and understand the Notice of Privacy Policy Practices.

Please click on the hyperlink to obtain a copy:

Form Completion

If Patient is a Minor

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