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WE WOULD LIKE TO INFORM YOU OF OUR OFFICE POLICIES
No Show Policy
If you are unable to keep your scheduled appointment, please notify us at least 24 hours in advance so we can accommodate our other patients. You may also reschedule your appointment at that time. Our no-show policy is as follows: a 24-hour notice is required. If you do not show for your scheduled appointment you (not your insurance company) will be charged $25 for the time slot we were not able to fill when you were a no-show. On the third no-show, it will be the physician’s discretion as to whether a discharge letter will be sent out disengaging you from the practice and giving you 30 days to enroll with a new physician. Persistently not attending for scheduled appointments without notifying the practice may also result in a suspension from AHCCCS (Medicaid) medical insurance.
Medical Record Policy
Each patient has a complete record of all medical care received at our office. Your personal medical record provides a history of treatment, medication, and diagnostic information that enables your health care team to make comprehensive medical evaluations. We consider your record to be confidential. Therefore, information will not be released without your written consent, unless required by law. Copies of your medical record will be released to you or transferred to another physician upon written consent. There will be a $25 - $50 copying fee for this service.
Completion of Forms (Work Comp, Disability, etc)
A $25-50 charge will be assessed for the completion of forms outside of an office visit. The charge varies on the length of the form and the time taken to complete.
I have reviewed the above policy.