Financial and Appointment Cancellation Policy
We strive to render excellent care to you and the rest of our patients. Your care and treatment are a priority to us. We also ask that you respect our physician’s time and expertise as well. In an attempt to be consistent with this, we have an appointment cancellation policy that allows us to schedule appointments for our patients, with respect for your time, the next patient’s time, and the doctor’s time.
Our policy is as follows:
I (patient, guardian, or legally authorized individual) am aware that I am financially responsible for all outstanding balances due to Crossroads Chiropractic. All outstanding balances due to our office should be paid in a timely manner. You (patient, guardian, or legally authorized individual) will have 60 after being sent first bill before late fees will apply. All unpaid balances will be sent to collections. If you need to make payment arrangements, please contact our office or let our staff know.
We (Crossroads Chiropractic) request that you (patient, guardian, or legally authorized individual) give 24-hour notice in the event that you cannot make it to your scheduled appointment. If you miss an appointment without contacting our office or reschedule or cancel an appointment with less than 24-hour notice, it is considered a “missed” or “no show” appointment. YOU WILL BE CHARGED $25.00 FOR THE VISIT YOU WERE SCHDULED FOR. In order to make another appointment you will need to settle your account prior to your next visit or for both visits prior to leaving your next adjustment. Additionally, if you are 10 or more minutes late for an appointment, it will be considered a “missed” or “no show” appointment, and that appointment will need to be rescheduled. Also, if you miss 3 or more appointments, Crossroads Chiropractic reserves the right to discharge you from the practice for failing to follow treatment recommendations.
You may contact the office via phone or email. Phone is preferred. Please see our business card with all our contact information.
If you have any questions regarding this policy, please let our staff know, and we will be happy to clarify the policy for you.
We look forward to being a continued part of your wellness.
I have read and understand the Financial and Appointment Cancellation Policy of Crossroads Chiropractic and I agree to be bound by its terms. I am aware that I must pay outstanding balances prior to making a new appointment or as otherwise worked out by staff.