201 W. Springfield Ave, Ste 1201 Champaign, IL 61820 Phone:(217)722-9079) Fax (217)501-4322
1002 Commercial Drive, Unit 2 Mahomet, IL 61853 Phone:(217)722-9079 Fax (217)501-4322
Appointment Reminders, Missed appointments, Cancellations, and No-Show Fees
To coordinate treatment, it is often necessary for our office staff or automated reminder system to leave you a message on your designated voicemail, email you on your designated email, or call/text you on your designated cell phone. We do our best to protect your confidentiality when leaving a verbal or written message. Signing this consent gives The Rock Counseling Group staff permission to leave voice, text, and e-mail messages. If you do not want messages left for you, please notify our office. A phone call and voicemail message, text message, or email received by your therapist or office support staff is necessary to cancel an appointment. Once an appointment is scheduled, you are responsible to pay for it unless you provide at least 24 hours in advance notice of cancellation. Insurance plans will not pay for missed or cancelled sessions; you will be charged a $45.00 missed session fee for every session missed without 24-hour
Our staff schedule appointments so that each patient receives the right amount of time to be seen by our therapist and counselors. That is why it is important that you keep to your scheduled appointment with us and arrive on time. As a courtesy, and to help patients remember their scheduled appointments, The Rock Counseling Group sends text messages, email reminders, and phone messages 3 days, 2 days, and 24 hours in advance of the appointment time. If your schedule changes and you cannot keep your appointment, please contact us within 24 hours so we may reschedule you and accommodate those patients who are waiting for an appointment. As a courtesy to our office as well as to those patients who are waiting to schedule with our providers, please do so with at least 24 hours' notice. If you do not cancel or reschedule your appointment with at least 24-hour notice, we will assess a $45.00 "no-show" service charge to your account. This "no-show charge" is not reimbursable by your insurance company. You will be billed directly for it, and it is required to be paid before your next session. After three consecutive no-shows to your appointment, our practice may decide to terminate its relationship with you. I understand the "no-show" policy of The Rock Counseling Group and agree to pay the fee explained above, which is $45.00 for any no-show of a scheduled appointment. I understand that I must cancel or reschedule any appointment at least 24 hours in advance to avoid a potential no-show charge to my
