No Show Policy

Navarre Pediatrics, P.L. NO SHOW policy is as follows:

Three missed appointment and your child may be discharged. Please make every effort to call and cancel your appointment in the event you cannot arrive on the date and time.

Cancellation should be 24 hours prior to your visit. Our office staff will be happy to reschedule any appointments that need to be changed.

Our office reminder calls are made the prior day of the visit. It is important to keep the office staff aware of any changes in your address and telephone numbers so you may be reached.

Thank you for allowing Navarre Pediatrics to care for your child’s health care needs.

Patient Name

Date of Birth

Parent or Guardian Signature

Date

Please list authorized individual(s) that may obtain medical treatment in the event that you are unable to bring your child to his/her appointment.

Name

Phone Number

Relationship

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