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Mind Over Matter NP in Psych. & Family Health P.C.
175 Jericho Turnpike Suite 117
Syosset, NY 11791
516-464-3006

APPOINTMENT CANCELLATION, LATE, AND NO-SHOW POLICY

You will be charged $100* for missed appointments, e.g., appointments that are not canceled 24 hours in advance (i.e., for Monday appointments, you must cancel by the appropriate time the preceding Sunday). In the case that you are more than 30 minutes late and/or do not show up to your
scheduled appointment, you are subject to the full no-show fee of $100.
In the event you cannot make it to your scheduled appointment, rescheduling for an appointment the same day will not waive a no-show fee.
If you miss or “late” cancel three consecutive sessions, your provider may discharge you from their service.
If at any time you want to discuss your financial obligations with us, we will be happy to make an appointment for you with the Mind Over Matter NP in Psychiatry and Family Health PC administrator.

By my initials, I acknowledge that I have read, understand, and agree to Mind Over Matter NP in Psychiatry and Family Health P.C. Appointment, Cancellation, Late, and No-Show Policy.

Initial Here: ____________________