Minimize Cancellations and No-Shows With This Form!

Every office should have an “Appointment Agreement” or “Appointment Policy” form as a part of their new patient packet. The form should be a one-page, easily understood request for a minimum of two business-days notice, should a patient need to change or cancel a dental appointment. I also suggest including a statement such as the following:“If shorter notice is given, and your previously reserved time goes unused, you may be charged for the value of the time lost to the practice, usually the fee for the procedure that you missed.”

To make the signed form three times more effective, when the appointment coordinator presents the form to the patient, they should allow the patient to read the form before signing, and then invite any questions about the office’s appointment scheduling practices.

(Sample Form available upon request – DrMike@GoldsteinManagement.com)

Dr. Mike Goldstein
Goldstein Management