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.

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Schedule automatic reminders to your patients to complete your forms before their appointment. Get more completed forms online before the scheduled appointment.

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Mobile-Friendly Forms

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File Attachment Upload

With file upload fields, your patients can upload their prescriptions, x-rays, medical records, insurance card photos and more with their form submission.

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FormDr gives your practice everything needed to easily send and receive HIPAA compliant forms online. 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