Office Appointment Attendance Policy
Name of adult/guardian signing the form (if client is under 18)
Client name if different from above
Please carefully review and acknowledge each item
At least a 24-hour notice is required to re-schedule your appointment. Requests for last minute re-scheduling disrupts the providers' availability and prevents others from taking your time slot. NO REFUNDS are given for no-shows or late cancellations (less than 24 hours).
For the safety and comfort of all clients, please arrive on time. Arriving late means your session will be shortened.
You may only bring a child to the appointment if this child is a client receiving direct services. Please make childcare arrangements (outside of the office) for young siblings who require adult supervision.
During your appointment I request you silence your cell phone and refrain from making/receiving phone calls. This includes reading/responding to text message as you are actively in the session and in front of the practitioner. This happens once in a while and is very disruptive. Please wait until you are done with the appointment to check your phone (unless of course you are needing your phone to check your calendar and book next appointment).
Should be Empty: