We understand that there are times when you must miss an appointment due to emergencies or obligations for work or family. However, due to extensive time needed for surgery, last minute cancellations may prevent another patient from getting much needed treatment.
If surgery is not cancelled at least 48 hours in advance you will be charged 50% of the surgery fee (for patients with deductibles) Or $75.00 (for patients with co-pays) that will be solely patient responsibility (not covered by insurance.
It is the policy of the Practice to monitor and manage appointments that are not kept. Commonly referred to as "no shows," these include any patients who fail to arrive for a scheduled appointment without cancelling the appointment less than 24 hours prior to the selected appointment slot.
In the event that a patient misses more than one appointment during a 12-month period without cancelling, the patient will be charged $50 for the second and third no-show. He or she may be required to prepay or to provide a credit card with an agreement that the fee will be charged if he or she fails to present for an appointment.
Atlas Dermatology understands that on occasion emergency situations may occur that prevent a 48 hour notice and sometimes even a 24 hour notice. In order to maintain sufficient availability we must adhere to the physician’s schedule. Inclement weather is one such situation that a notice is not possible. These cases will be handled on an individual basis at the discretion of Atlas Dermatology.
Please sign and date below to indicate that you have been made aware of the Surgery Cancellation Policy and the Appointment No Show Policy.
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