Description

** I agree and by paying this deposit, for your reserved dental appointment, you have read, agree and understand the Policy below. You also acknowledge that any changes to this appointment MUST be done as soon as possible. If not, and changes are less then 48 business hours your Deposit of $25.00 will be forfeited to cover your Cancellation fee. To make another dental appointment an additional $25.00 will need to be paid to reserve that new appointment time.

A $25 deposit is required for all self-pay patients to schedule and keep your appointment. This applies to all of our medical office locations with scheduled appointments (day and times).

DEPOSIT & CANCELLED, RESCHEDULED, MISSED, NO SHOW APPOINTMENT 48 Business Hour POLICY:

Due to the high number of “No Shows”, TPI’s has implemented a new policy. This policy  includes:

    – A Deposit of $25.00 to schedule appointments for patients who do not have insurance coverage and will be paying out of pocket: 

• For patients with no insurance and paying out of pocket for dental care, a deposit of $25.00, per patient/ per appointment is required to schedule and keep your dental appointment.
• Please be on time for your reserved appointments. We have exclusively reserved the hygienist and facility for your personal dental care.
• The day of your appointment the $25.00 deposit will be subtracted from your total bill for the scheduled appointment.

   – 48 business hour (Monday- Friday) Cancellation/ Reschedule policy:

• If you need to cancel or reschedule, please make sure to do so in advance or at a minimum of 48 business hours (Mon-Fri) prior to your scheduled appointment to avoid any fees.
• If you need to cancel or reschedule BEFORE/ more than 48 hours from your scheduled appointment an appointment, please let us know 48 hours in advance and we will move the appointment once without having to pay the deposit fee again.
• If an appointment is cancelled or rescheduled AFTER / less then 48 business hours before the appointed time, the $25.00 deposit will be retained to cover your Missed / No Show appointment/cancellation fee. To make a new appointment, an additional $25.00 deposit fee will need to be paid to reserve that new appointment.

– Missed / No Show / Cancellation / Reschedule Appointment fee of $25.00:

• If an appointment is cancelled or rescheduled AFTER / less then 48 business hours before the appointed time, the $25.00 deposit will be retained to cover your Missed / No Show appointment/cancellation fee. To make a new appointment, an additional $25.00 deposit fee will need to be paid to reserve that new appointment.