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cancellationpolicyOPK

Updated: 8/2013
VITAL REHABILITATION Pediatric Therapy Program Effective 2/6/2014
PRO VITA SANA

CANCELLATION & ATTENDANCE POLICIES
Early Intervention & Pediatrics

Unfortunately, due to frequently missed appointments and late arrivals, we have had to update our
attendance policies. If the following policies are not followed, your childs therapy sessions may be cancelled
and your child may be discharged from therapy.

Cancellation/No-show Fee: For every cancellation with less than 24 hours notice or no-shows, you will be
charged a $35.00 cancellation/no-show fee. Cancellation fees must be paid prior to, or at the time of, your
next scheduled appointment.

No-Show policy: After a total of 3 no-show appointments or cancellation with less than 24 hr notice, your
childs scheduled therapy time may be cancelled and your child may be discharged from therapy. No-show
appointments are defined as the therapist or office not receiving a call prior to the appointment and your child
not showing up for the scheduled appointment.

Consistent Cancellations with notice: If your childs therapy sessions are consistently being cancelled due to
any reason, your childs scheduled therapy may be cancelled and your child may be discharged from therapy.
Consistent cancellations are defined as missing 30% or more of your childs scheduled therapy sessions.

Late Arrival: If you are 10 minutes late for your childs appointment, your child will still be seen but you will be
charged a $15 late fee. If you arrive more than 20 minutes late, your appointment will be a cancellation and
you will be charged a $35 cancellation fee.

Time Off from Therapy: If your child needs to miss more than 1 week from therapy for any reason, we cannot
guarantee the same time slot when your child is ready to return. If your child needs to miss more than 4
weeks from therapy for any reason, your child may be discharged from therapy.

Calling the office to cancel: Our office is open 8:00am-8:00pm and Monday-Friday, and 8:00am-1:00pm on
Saturdays. There is an after-hours answering machine. If your child is sick the day of the appointment you
must call and leave a message at least 24 hours prior to your scheduled appointment to avoid the
cancellation fee.

The phone number is: 773-685-8482.
However, if this is done on a consistent basis, then your child may be in danger of being discharged for non-
participation.

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Parent/Guardian Date

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