You can open the No Show Letter To Patients Template in multiple formats, including PDF, Word, and Google Docs.
No Show Letter To Patients Template Printable | Editable FormSample
Examples
[Patient’s Name]
[Patient’s Address]
[Patient’s Phone]
[Patient’s Email]
[Your Practice’s Name]
[Your Practice’s Address]
[Your Practice’s Phone]
[Your Practice’s Email]
[Date]
Notice of Missed Appointment
We are writing to inform you that you did not attend your scheduled appointment on [Appointment Date] at [Appointment Time]. We understand that unforeseen circumstances may arise, but we would like to emphasize the importance of attending your appointments or notifying us in advance if you cannot make it.
Please note that our practice has a policy regarding missed appointments, as it can affect our scheduling and other patients’ access to care. If you continuously miss appointments without prior notice, you may be subject to the following actions:
We will notify you after a certain number of no-show instances.
A no-show fee may be assessed after repeated missed appointments. This fee helps cover the time reserved for your visit.
In the event of persistent no-shows, we may consider discharging you from our practice, and you will need to find another healthcare provider.
Your health and well-being are of utmost importance to us, and we encourage you to reschedule your missed appointment as soon as possible. Please contact our office at [Your Practice’s Phone] or [Your Practice’s Email] to arrange a new time.
We understand that circumstances may change, and we appreciate you taking the time to inform us when they do.”
Sincerely,
[Your Name]
[Your Position]
[Your Practice’s Name]
[Patient’s Name]
[Patient’s Address]
[Patient’s Phone]
[Patient’s Email]
[Your Practice’s Name]
[Your Practice’s Address]
[Your Practice’s Phone]
[Your Practice’s Email]
[Date]
Missed Appointment Notification
We regret to inform you that you missed your appointment scheduled on [Appointment Date] at [Appointment Time]. We understand that situations may arise that prevent you from attending, and we would like to reiterate our commitment to providing you with the best care possible.
Missed appointments prevent us from serving other patients who require timely care. Our goal is to ensure that each patient receives the attention they need, and your cooperation in attending scheduled visits is essential to achieving this.
We recommend that you contact us immediately to reschedule your appointment. Our team can be reached at [Your Practice’s Phone] or [Your Practice’s Email]. We will do our best to accommodate you at a convenient time.
To avoid any future concerns regarding missed appointments, we kindly ask you to notify us at least [X hours/days] in advance if you cannot attend. This allows us to offer your slot to another patient in need of care.
We appreciate your understanding and look forward to continuing to support your healthcare needs.
[Your Name]
[Your Position]
[Your Practice’s Name]
Format
Please complete the form below to create the No Show Letter to Patients Template. All fields must be filled out to ensure a clear and professional communication. We provide examples to guide you through each step. No Show Letter to Patients Template 1. Patient Information 2. Appointment Details 3. Reason for Letter 4. Impact of No Show 5. Rescheduling Options 6. Policy Reminder 7. Encouragement Statement 8. Practice Contact Information 9. Signatures and Acknowledgment
PDF
WORD
Google Docs
No Show Letter To Patients Template Printable | Editable FormPrintable
