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The Best Cancellation Policy Template

Follow our guidelines for creating a well-drafted appointment cancellation policy.

When a patient fails to show up for the scheduled appointment, it does not just affect the patient but also has a bearing on the practice. Some physicians don’t even know their no-show rate, let alone understand the cost of missed appointments.

Missed appointments cost healthcare units as much as $150,000 in labor costs and lost revenue annually. For a multi-physician office, the damages may be much higher, reaching up to one million dollars.

Physicians should not ignore the losses of this magnitude. Whether the practice is big or small, even a minor no-show rate may result in huge losses. Here are ways that can help you reduce the patient no-show rate and improve the overall performance of your practice.

Before you draft an appointment cancellation policy, ask yourself these questions

  1. Will a booking fee be charged before the service?
  2. Are you willing to refund the full/partial amount?
  3. How long before the appointment must customers inform you of their incapability of showing up? 
  4. Do you want to charge a cancellation fee if the appointment is not canceled within the set time?

Create an Appointment Cancellation Policy

Here is a 7-step guide on how to create a better appointment cancellation policy.

1. Help Patients Remember Appointments

The good news is that if you’re an Appointment Reminders customer you’re already doing this. Most no-shows are about forgetting the time or day of an appointment, and nobody does that on purpose. Give patients a little help by sending appointment reminders. For better results, give your patients a choice between a call, text message, or email appointment reminders. What works best for your patient, will work best for you. You might even consider sending out appointment reminders in different languages.

2. Stop Telling Your Patients to Cancel Appointments!

Avoid appointment-reminder commands such as press 1 to cancel or click here to cancel. These not only sound like they are telling the patient to cancel, but they also make it too easy to do it on impulse. Even the best of us might get tempted to cancel a root canal if it takes one keypress!
A better script sounds like this: press 1 to transfer to our office or please call our office at (232) 323-2323 with any questions. Take the word cancel out of your reminder vocabulary. Place the focus back on assisting your patients. Set up a script that lets your staff talk to the patient and make sure they reschedule. As a bonus, your staff can find another patient to book if they learn about an open slot.

3. Set a Cancellation Fee

Cancellation fees work well with patients who call at the last minute to cancel. Many patients will decide not to cancel once they know that there’s a fee. Some providers charge a nominal fee, while others charge the entire cost of the appointment. Consider what a missed appointment costs you will have. Add up overhead costs and set a fee that reflects those losses.

4. Make a Cancellation Cut-Off Time

A 24-hour appointment cancellation policy is not always effective in healthcare. Let’s say your patient has a family emergency at 2 pm. He knows he can’t keep his appointment with you the following morning at 8 am. He’s already missed the 24-hour cancellation window. So why call you at all?

The 24-hour cancellation window doesn’t work that well on weekends either. Is it ok for patients to cancel their 9 am Monday appointment by 9 am on Sunday? Is your staff there on Sunday to reschedule the appointment? Or does this create Monday no-shows?

A different strategy is to set an appointment cancellation policy cut-off time. For example, let your patients know they must cancel before 2 pm the day before the appointment to avoid a fee. If their appointment is on Monday, the cut-off time is 2 pm on Friday. This gives the staff enough time to offer the appointment to someone from the waiting list. Some appointment types may need an earlier appointment cancellation cut-off. Surgeries and procedures, for example, are difficult to reschedule so you can adjust the appointment cancellation cut-off time as needed.

5. You Determine When to Waive the Fee

There are instances when you may decide to waive your appointment cancellation policy fee and that’s fine. The key to a consistent appointment cancellation policy is to define exceptions ahead of time. This way, your staff never has to decide while the patient is standing in front of them.

For example, many practitioners give each patient one free pass. Some waive the fee if the no-show was unintentional or due to an emergency. Some decide to be more lenient with patients who have dementia or other forms of mental illness. Empower your staff to make the right decisions by including detailed instructions in your policy.

6. Communicate Your Appointment Cancellation Policy to Your Patients

Communication is the key to having an appointment cancellation policy that effectively reduces no-shows. Have all patients signed your appointment cancellation policy? Place a notice in the lobby describing the cancellation fee. Print your policy on patient forms. Post it on your website.

7. Communicate Your Appointment Cancellation Policy to Your Staff

Communicating to your staff is just as critical. Train your staff to communicate your appointment cancellation policy with kindness. Explain that many no-show patients are not irresponsible, they are simply experiencing a problem. If someone cancels at the last minute, train staff to explain that the appointment is an important part of the treatment. Have them suggest that they keep the appointment if possible. They can even say that they don’t want to charge them a cancellation fee but will have to abide by the policy. This is an uncomfortable topic, so you may want to provide a script.

Many times, such an approach gets the patient to keep the appointment. Most will remember signing your appointment cancellation policy, but if there is a cancellation, your staff will know whether they can waive the fee thanks to the guidelines you have put in place.

Appointment Cancellation Policy Template

(Company Name) is committed to providing exceptional care. Unfortunately, when one patient cancels without giving enough notice, they prevent another patient from being seen. Please call us at (323) 232-3232 by 2:00 p.m. on the day before your scheduled appointment to notify us of any changes or cancellations.

To cancel a Monday appointment, please call our office by 1:00 p.m. on Friday. If prior notification is not given, you will be charged $(insert amount) for the missed appointment.

Please sign below to consent to these terms.

Client Signature (Client’s Parent/Guardian if under 18)


Cancellation Policy Example

“Our [Company Name] operates on a scheduled appointment basis. When canceling an appointment, we require all customers to provide MORE than 24-hour notice to the scheduled time.

Otherwise, we will charge customers for the full session. We will provide a one-time cancellation fee waiver, where customers can cancel a session in less than 24 hours, at no additional charge.

Alternatively, we will offer one free appointment upon rescheduling. The free session will need to be scheduled within 7 days of the cancellation.”

24-hour Cancellation Policy Example

We realize that emergencies and other scheduling conflicts arise and are sometimes unavoidable. However, advance notice allows us to fulfill other patients’ scheduling needs and keeps the clinic operating at its most efficient level. Due to our one-on-one, 60-minute treatments, missed appointments are a significant inconvenience to your physical therapist, the clinic, and other patients. This policy is in place out of respect for our therapists and our clients.

Cancellations with less than 24-hour notice are difficult to fill. By giving last minute notice or no notice at all, you prevent someone else from being able to schedule into that time slot and leave a 60-minute hole in your therapist’s schedule.

  1. Please provide our office with 24-hour notice to change or cancel an appointment. Patients who do not attend a scheduled appointment or do not provide 24-hour notice to change a scheduled appointment may be responsible for a $75.00 service charge. This charge cannot be billed to insurance and must be paid on or before the next scheduled appointment.
  1. We reserve your one-hour appointment time just for you. We do not double-book our patients so that we may provide optimum treatment outcomes for all our patients. 24-hour notice allows us to offer that time to a wait-listed patient.
  1. Certain accident claims adjusters expect regular attendance to physical therapy as a requirement of an approved treatment plan. If appointments are missed or canceled regularly it could affect the status of your claim. Your treatment plan has been established by your medical practitioner(s) to get you back to your regular activities as quickly as possible. Missing appointments hinders that process and may end up prolonging recovery.
  1. After two missed or canceled appointments without the appropriate 24-hour notice, you may be placed on a same-day scheduling policy for your treatments, which would not allow you to schedule any appointments in advance.

NOTE: You will never be charged for a cancellation if it is made more than 24 hours in advance of your scheduled appointment time. Thank you for providing our office and our patients with this courtesy. I have read, understand, and agree to abide by the policy above: Print Name:

__________________________________                                    ___________________

Signature of Patient (or Responsible Party)                                Date

No-Show Policy Template

Dear [Practice Name],

We schedule our appointments so that each patient receives the right amount of time to be seen by our doctors and office staff. That’s why it is very important that you keep your scheduled appointment with us and arrive on time. As a courtesy, and to help patients remember their scheduled appointments,

We sent [Practice Name] text messages and email reminders 5 days, 2 days, and 2 hours in advance of the appointment time. If your schedule changes and you cannot keep your appointment, please contact us so we may reschedule you. (To accommodate those patients who are waiting for an appointment.) As a courtesy to our office as well as to those patients who are waiting to schedule with the doctor, please give us at least 24-hour notice.

If you do not cancel or reschedule your appointment with at least 24-hour notice, we may assess a $[INSERT YOUR FEE] “No-Show” service charge to your account.

This “No-Show charge” is not refundable by your insurance company. You will be billed directly for it. After three consecutive No-Shows to your appointment, our practice may decide to terminate its relationship with you.

     (Please check)

I understand the “No-Show” policy of [Doctor’s NAME] and agree to provide a credit card number, which may be charged $[INSERT YOUR FEE] for any No-Show of a scheduled appointment.

     (Please check)

I understand that I must cancel or reschedule an appointment at least 24 hours in advance to avoid a potential no-show charge to the credit card provided.

Leave space at the end of the form for patients to print and sign their name & date.

 ___________________                ____________________

     Patient’s Name                                         Date

Use our Cancellation Policy Generator to Create Your Own Custom Template

Cancellation Policy Generator

Having an appointment cancellation policy might seem like a harsh approach to maintaining client relationships. But at the end of the day, it is your business objective to save time and money. And you are saving the client’s time as well! Appointment Reminders can help in reducing no-shows significantly by automating processes like sending reminders, confirmation emails, calls, texts, and more. 

No Contracts and No Risk!

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