No Show Policy
Effective June 1, 2017
Patients who fail to keep scheduled appointments, the following occurs.
*24 –hour notice minimum required for cancellation via phone or patient portal*
• Patient is contacted by phone (attempts 1) and all patients by letter.
• If missed appointment occurs twice, patient is dismissed from the practice unless there are
• Patients (all) are charged a broken appointment fee.
Download Patient Forms
Quickly and conveniently obtain forms from our office. By filling out these forms ahead of time, you will save time during your visit.
Note: These files are in PDF format. If you do not have Adobe Reader on your computer, you can download it for free at www.adobe.com
If you need to request medical records for transferring to other physicians or transferring into our office, please select the appropriate form below. You may mail, deliver or email firstname.lastname@example.org the completed form to our office. Signatures must be verified prior to transferring.