NEW PATIENT FORMS - Wisdom Eric J DDS PA

1629 Poyntz Ave

Manhattan, KS 66502

Phone: 785-776-1771

(Main Office)

712 6th Street

Clay Center, KS  67432

Phone: 785-632-2400

(Satellite Office)

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Dr. Eric J. Wisdom

D.D.S., P.A.

NEW PATIENT FORMS

(Forms to print off for new patients)

POLICY CHANGE

 

Scheduled treatments are reserved especially for you.  Please understand that when you forget or cancel your appointment without giving enough notice, we miss the opportunity to fill that appointment time and patients on our waiting/call list miss the opportunity to receive services they need.  In the event we do not receive the required notice for adjustments and cancellations, the following fees will be applied to your account and you will not be able to schedule another appointment until you pay the $25 per scheduled hour Missed/Cancellation Appointment Fee.  If notification is given within 24-hours prior to your appointment, you will receive no charges.  We do understand that things happen unexpectedly and we will work with you.

 

Thank You for Your Understanding,

 

Eric J. Wisdom, DDS and Staff