Cancellation Policy

CANCELLATION POLICY:

PLEASE NOTE – WE HAVE MANY PATIENTS WHO HAVE BEEN WAITING A LONG TIME FOR APPOINTMENTS WITH OUR SPECIALISTS. IN CONSIDERATION OF THEM, AND OUR OWN STAFFING CONCERNS, WE WOULD APPRECIATE IT IF YOU NEED TO CANCEL YOUR APPOINTMENT YOU GIVE US AT LEAST 24 HOURS NOTICE. At our discretion, APPOINTMENTS CANCELLED WITHIN 24 HOURS WILL INCUR A $25 CANCELLATION CHARGE.    

Name (please print): _________________________________

Signature:  _________________________________________

Date: _____________________________