Ramirez Dermatology | No Show Policy

 We are grateful that you trust us with your dermatology concerns. The purpose of this policy is to ensure that all patients receive timely and necessary care. Unfortunately, there are individuals who fail to keep their scheduled appointment which prevents other patients from being seen at that time. Valuable staff time is also lost in preparing for office visits and stops me from giving

appropriate medical care.  I ask that you give my office at least 24 hours’ notice if you need to cancel or reschedule an appointment to allow other patients the opportunity to use this time.

Please arrive at least 15 minutes prior to your scheduled appointment. Failure to do so will be considered a “no show” appointment. Calling the day of your appointment to reschedule or cancel your appointment will also be considered a “no show” appointment.

No show appointments have consequences that require you to pay $50 to schedule a future visit with us. Your insurance company will not pay for this expense.  It is your personal responsibility.

After two “no show” appointments, you may be dismissed from our practice for noncompliance and lose the opportunity to schedule an appointment in our dermatology clinic. I sincerely appreciate that you trust our clinic providers and staff with your care.  I look forward to seeing you.  Please accept this policy as a means of providing my patients the best care possible and let me know if he has any questions or concerns.

I __________________________ have been given a copy, read and understand this policy.

                      (Print Name)

________________________________              _______________________

                      (Signature)                                                       (Date)