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LATE APPOINTMENT POLICY

1. POLICY

At [NAME OF CLINIC/INSTITUTION], we put our faith in you to keep your appointment and be on time.
We know you put your faith in us to see you on time as well as take good care of you. When we schedule
an appointment, a specific amount of time is reserved especially for you.

We understand that sometimes unexpected circumstances arise that may cause you to be late for your
appointment. However, to provide the best possible care to all our patients, we have implemented a Late
Appointment Policy.

The policy of the healthcare provider's practice is to monitor and manage appointment no-shows and late
cancellations. If it is necessary for the patient to cancel an appointment, patients are required to call or
leave a message to cancel it. Notification allows the practice to better utilize appointments for other
patients in need of prompt medical care.

2. PURPOSE

The healthcare provider's purpose is to provide excellent care and proper treatment to each patient in a
timely manner. The healthcare provider shall not discriminate among its patients and would not give
preference unless for an emergency case. Then the healthcare provider has the complete authority to
give preference to the patient in emergency need of help. The healthcare provider shall have complete
authority to decide the provisions of emergency case.

3. SCOPE

This Policy applies to all patients and staff who work for or on behalf of [NAME OF
CLINIC/INSTITUTION], regardless of their role or location.

If you are late: When we reserve time for you, we require all of that time to provide you with the best
quality care possible. When you are late, it decreases our ability to accomplish this. If you arrive more
than 10 minutes late for your appointment time, you may be rescheduled in order to meet the needs of
those who are on time. Priority will be given to the patients who arrive on time. One or two late patients
can cause the entire daily schedule to fall behind. This is an inconvenience to everyone. We strive to see
every patient as close to their appointment time as possible.

4. DEFINITION OF LATE ARRIVAL, NO-SHOW AND SAME DAY CANCELLATION

“Late Arrival” shall mean any patient who arrives at the clinic 15 minutes after the expected arrival time for
the scheduled appointment.

“No-Show” shall mean any patient who fails to arrive for a scheduled appointment.

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“Same Day Cancellation” shall mean any patient who cancels an appointment less than 24 hours before
their scheduled appointment.

5. APPOINTMENT

Patients are expected to arrive on time for their scheduled appointments. If a patient anticipates being
late, they should call the healthcare provider's office as soon as possible to inform them of the delay.

6. POLICY AND PROCEDURE OF HEALTHCARE PROVIDER

A patient is notified of the appointment “No-Show, Late, & Cancellation Policy” at the time of scheduling.
This Policy can and will be provided in writing to patients at their request.

The following factors must be considered:

 Please provide our office a 24-hour notice in the event that you need to reschedule your
appointment. This will allow us the opportunity to provide care to another patient. A message can
always be left with the answering service to avoid a cancellation fee being charged.

 In the event a patient arrives late as defined by “late arrival” to their appointment, and cannot be
seen by the provider on the same day, they will be rescheduled for a future clinic visit, if available.
If appointments are not yet available for their provider, a reminder will be placed for the patient to
call to make a future appointment once the schedule opens.

 A “No-Show” is a patient who fails to appear for a scheduled appointment without providing a 24-
hour cancellation notice.  Further, a rescheduled appointment that is less than the 24-hour
cancellation notice is still considered a cancellation and is treated as such. There is a [SPECIFY
CHARGE] charge for all No-Shows.

 Missed appointments create a hardship for everyone. Our physicians’ schedules are full, and in
high demand. If you miss your appointment, you may have to wait a long time to get another
appointment. Please do not miss your appointment.

 As a courtesy, we make reminder calls for appointments, one to two days in advance. Please
note, if a reminder call or message is not received, the Cancellation Policy remains in effect.

 Repeated missed appointments may result in termination of the physician/patient relationship.

A physician assistant or a nurse practitioner may have to step in when your doctor is not available or has
to handle an emergency. These trusted individuals may see you in lieu of your doctor, and the same rules
apply. They are aware of your doctor’s practice methods as well as being in constant contact with them.
You can be sure that you will still get the best care possible when seeing them.

Sometimes a patient comes in that requires additional attention. This can cause the doctor to run late for
the rest of the day. We will do our very best to notify you when this happens. We hope we can make you
as comfortable as possible while you wait. If you would like to go and get a cup of coffee, shop or eat
while waiting, we can call you on your cell phone when the doctor is ready. You may also prepare for the
wait by bringing a book to read or something you enjoy doing before your appointment. Free Wi-Fi is
available.
7. RIGHT TO TERMINATE AND AMEND THE POLICY

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The healthcare provider reserves the right to modify, suspend, change, or terminate this Policy at any
time, in accordance with local law. This Policy does not create any contractual rights or obligations,
whether expressed or implied. Subject to local law, the English-language version will prevail.

8. CONTACT

Any questions about this Policy should be referred to [NAME] [PHONE NUMBER; EMAIL ADDRESS],
who is in charge of administering, enforcing and updating this Policy.

[NAME OF CLINIC/INSTITUTION]

Authorized Signature

Print Name and Title

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