Cancellation & No-Show Policy template

1. Notice Required

• I agree to give at least 24 hours' notice to cancel or reschedule any appointment, unless a longer period is specified for a particular service.

2. Late Cancellation and No-Show Fees

• Late Cancellation FeeText
• No-Show FeeText

• Cancellations made with less than the required notice, and appointments missed without notice, will be charged at the rate stated below. Fees may be waived at the Provider's discretion in genuine emergencies.

3. Repeated Missed Appointments

• Repeated late cancellations or no-shows may result in a requirement to pre-pay for future appointments, or, in persistent cases, discharge from the service.

4. How to Cancel

• Cancellations should be made by phone or email using the contact details provided by the Provider, as early as possible.

Client Information

• Full NameText
• Phone / EmailText

Provider Information

• Provider NameText
• Contact for CancellationsText

Emergency Contact

• Contact NameText
• Relationship / PhoneText

Acknowledgment and Signature

• Client SignatureSignature
• Date signed (client)Date

• By signing below, I confirm I have read, understood, and agree to this cancellation and fee policy.