Policies & General Information

 APPOINTMENT CANCELLATION POLICY: 

When you schedule an appointment with us, that time is specifically reserved for you alone. 

  • If you miss an appointment or fail to cancel 24-hours before your appointment time, you will be charged $50.

  • New Patient Appointments that cancel without a 24 hour notice, no show, or fail to return required paperwork and consents will be cancelled and charged $100.

  • You will also be charged a No-Show-Fee of $50 if you arrive late and must be rescheduled for another day.

  • After 3 No Shows, we have the right to terminate you from our practice.

The only exception to this fee is if you can provide documentation. Documents that may be considered are doctors notes, legal documents such as court paperwork or tickets, and school related excuses.

Please note that although we do offer courtesy email, text message, and phone call reminders, the patient is responsible for remembering his/her appointment. Not receiving an appointment reminder will not be considered an excuse for missing an appointment. Insurance companies do not reimburse for these fees.

 PRESCRIPTION REFILLS: 

To help ensure safety and well-being, patients are expected to follow-up within the time frame recommended by their provider. Prescriptions will be given at each appointment with enough refills to last until the recommended time of your next appointment. If your refills are running low, it likely means it is time to schedule a follow-up appointment.

Before calling our office to request a refill, please check your bottle or call your pharmacy to see if you have any refills remaining. Requets must be made directly from patients, pharmacy auto requests will not be filled.

PLEASE ALLOW AT LEAST 3 BUSINESS DAY TURNAROUND FOR REFILL REQUESTS. NO REFILLS WILL BE GIVEN ON FRIDAYS.

PAPERWORK:

New patient paperwork is required to be completed 7 days after the initial scheduled time. This includes Clinical History forms, any measures assigned, and the New Patient Packet, which contains HIPAA forms, ROI, Consent, Policies, and PHQ9. If the paperwork is not completed within the time frame given, your appointment will be rescheduled for a later time.

Occasionally, you may need a letter or documentation for school, employer, or other entity regarding your care. Although it may be a simple document, we do have several patients that are requesting paperwork.

PLEASE ALLOW A 2 WEEK TURN AROUND TIME FOR ANY REQUESTED PAPERWORK.

Any patient requesting medical records will need to provide a Release of Information form. This form can be sent or picked up at the office.

THERE IS A 10 DAY TURN AROUND TIME FOR MEDICAL RECORDS.

Fees may apply and are listed below.

 FEES: 

The patient’s portion of the payment is due at time of service. This includes copays, deductibles, and any past due balances. Appointments that have a past due balance will need to be paid 24hrs before the appointment time or the appointment will be canceled and a $50 No Show fee will apply.

There is a $25 charge for returned checks.  

Balances over 90 days may be sent to a collection agency.

Medical record request fees are $30.

All FMLA/Workplace Arrangement Forms / Disability Forms or any other paperwork needing to be completed will be a $30 charge, this will need to be paid out of pocket as insurance does not cover this service.

In a special circumstance, if a payment plan is set up, a patient must be in good standing with that payment plan. The patient is also responsible for any new charges incurred at the time of service.

 INSURANCE:

Insurance coverage varies among our different providers. Please contact your insurance company or the office for specific questions or concerns.