APPOINTMENT CANCELLATION

As a patient receiving services from Modern Dentistry, I understand that I am responsible to cancel appointments within a 48 hour timeframe. Failure to cancel an appointment within 48 hours is considered a No-Show.

The following will apply:
1) The patient will be expected to arrive on time for a scheduled appointment.
2) The patient will be expected to cancel an appointment 48 hours in advance by telephoning the Modern Dentistry office for notification during regular office hours.
3) If the patient fails to telephone/email the Modern Dentistry office to cancel an appointment, it will be considered a “No-Show”.
4) If the patient fails to show for an appointment, the patient will be notified first by telephone and will be given an opportunity to reschedule the appointment.
5) If the patient cannot be reached by telephone, the patient will receive an email or text regarding the need to contact the doctor’s office to arrange for follow-up. (A copy of the letter is maintained in the patient chart)
6) Failure to cancel an appointment due to hospitalization, adverse weather conditions, or other unusual circumstances will NOT be considered as failure to cancel an appointment.
7) The patient may be terminated from the doctor’s services after three (3) documented no-show appointments within a 12 month period.
8) Prior to terminating services, a letter will be sent from the doctor to the patient explaining the reason for termination.
9) The termination letter will state that the patient can see the doctor on an emergency basis for 30 days from the date of the notification of termination of services. Regular or non-emergent appointments will NOT be scheduled during this 30 day period of time.
POLICY: Staff will attempt to remind the patient before their scheduled appointment. This is a courtesy service that we provide and does not relieve the patient from their responsibility to arrive for their scheduled appointment. Patients who consistently fail to present themselves for a scheduled appointment will be considered Chronic No-Shows.
Three (3) no-show appointments in a 12 month period may result in the patient’s dismissal from this practice.

1997 Ocean Avenue, Brooklyn, NY 11230 USA
Daniel Bernstein, DDS Brooklyn NY dentist (718) 339-6000