****NEW POLICY STRICTLY ENFORCED PLEASE READ, Print and sign.***

Appointment Cancellation Policy Agreement &

New Patient Paperwork and Arrival Time

Eagle Acupuncture is committed to providing all of our patients with exceptional care. When a

patient cancels without giving enough notice, they prevent another patient from being seen.

New Patients must fill out all of their paperwork PRIOR to arriving for their first appointment.

Our paperwork is extensive and needs to be filled

out before arriving.  Not having it filled out can make it impossible for your practitioner to see you, however, you will be charged for your visit.

_____Initial HERE to agree to have paperwork filled out before your arrival.

If you have completed your paperwork you need to arrive for your initial appointment 30 minutes PRIOR to your scheduled appointment time. If your appointment is at 12pm arrive by 11:30am.

_____Initial HERE to agree to arrive 30 minutes before your initial scheduled appointment time.

Please CALL us at (208) 938-1277 48 hours prior to your scheduled

appointment time to notify us of any changes or cancellations. To cancel a Monday appointment,

please call our office before 5:30pm on Friday.

If prior notification is not given, you will be charged the cost of your scheduled appointment for the appointment you missed.

This policy will be strictly enforced with no exceptions.

Sign Here to Agree to Policy for Patient or Parent for Minors:

________________________________________________________________