The Children's Dental Center - Hernando
If you find the need to reschedule or cancel an appointment for your child, please give our office at least 24 hours' notice if possible for all cleaning and dental treatment appointments. We require a 3-day cancellation notice for all booked hospital cases. Our office reserves the right to charge a $50 fee for any missed appointments. All fees must be paid before rescheduling another appointment.
If you miss 2 appointments without notifying our office, we reserve the right to refuse rescheduling the appointment for your child or to dismiss your child from our practice. You may leave a message at 662-298-2105 any time of the day or night. We ask that you let us know if your child will miss their appointment, or if you will be running late, so that we may adjust our schedules accordingly.
Once you miss 2 appointments without calling 24 hours in advance, you must call our office the morning of to be a walk-in patient. We can no longer book an appointment in advance for your child.
By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
Your information will be encrypted.
Your browser does not support capabilities required for electronic signatures.
Click a signature you want to use: