Cancellation Policy Form Template

Easily decrease no-shows and late cancellations by sending and receiving the clinic cancellation policy in advance. By acknowledging the policy prior to a scheduled visit, patients are well-informed and can conveniently sign the form from their phone, tablet, or computer.
Cancellation Policy

Cancellation Policy Form Template

Give your patients the freedom to complete cancellation policy forms with any device, anywhere. Streamline the way you collect signatures and consent forms by setting up your form online.

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What is a Cancellation Policy form?

Practices and offices adhere to a tight schedule to see as many patients as possible each day. When people fail to show up for a scheduled visit or cancel with very little notice, then this prevents others from taking the appointment slot. Practices can advise patients of the cancellation policy ahead of time to avoid these situations and encourage good communication.

No-shows occur, when a patient fails to attend a scheduled appointment with no prior notification to the healthcare provider. They are missed healthcare utilized time slots and resources that can negatively affect the utilization of space and human resources…….For instance, in a recent study, it was estimated that 67,000 no-shows can cost the healthcare system approximately $7 million.

The liability falls on you to handle patient data in a compliant way. Patient privacy is a serious topic, legislation from the Health Insurance Portability and Accountability Act to the Patient Protection and Affordable Care Act place heavy fines on medical professionals who mistreat patient information.

A medical release form does not empower your staff to share patient information with just anyone. Depending on what is included in the form, the document may release medical information to the patient’s family, other doctors, insurance providers, attorneys, or anyone who may make healthcare decisions on behalf of the patient.

Discover More Form Features

Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
Mobile Friendly Forms

Mobile-Friendly Forms

Easily build fully-responsive medical forms online that allow your patients to sign and submit on any device, anywhere, at any time.

Export to PDF

Export Form Submissions to PDF

Quickly export complete patient forms to a PDF file. Save completed forms as a PDF to quickly attach patient records.

Custom Thank You Page

Custom Thank You Page

Create your own custom ‘Thank You’ page to direct patients to upon completion of your forms. Forward them along to the next steps of your intake process.

Sync HIPAA Compliant Appointments with Google Calendar

Sync Appointments with Google Calendar

Authenticate your Google Calendar to receive appointment dates and times from your account.

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  • Sending a PDF was too time consuming for the patients to do, and it required the additional steps of printing and scanning it into our own systems. FormDr made it easier to get patients to complete the forms by email, and it’s a more secure way to provide info than simply emailing back a completed PDF.

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Schedule a consultation with us to learn more

FormDr gives your practice everything needed to easily send and receive HIPAA compliant online forms. We help practices who:

  • Are having patients fill out paper forms during the appointment
  • Are emailing patients a PDF or Word Doc to print out, fill out, scan, and send back
  • Are spending time manually printing and scanning paper forms