Appointment Policy

Garden Pediatrics works to ensure a smooth visit experience for each of our patient families. When you arrive at Garden Pediatrics,
you expect a rapid check-in process, minimal wait time for an exam room, adequate time with your provider and an efficient
checkout process. Performing this consistently for every patient, every time is our commitment to you. As needed, we will make
adjustments to our policy to ensure we can achieve our commitment to each of our Garden Pediatrics families.

Just as we make a commitment to you, your request for an appointment time is your commitment to us that youll arrive on time.
We are counting on you to keep your commitment. This ensures the best opportunity for you to be satisfied with the entire visit
experience.

To accomplish this experience, the appointment and check-in process is critical and is as follows:

Appointment Time
Check-in Procedures
Form Completion
Payment
Insurance Validation

10 minutes

Patient Preparation
Vitals
Initial Visit Review with medical staff

10 minutes

Provider Review
10-20 minutes, based
on appointment type

Time with physician or nurse practitioner

Exit Procedures
5-10 minutes

Next appointment
Payments follow-up
Vaccination record completion

If you are late, we will work with you to reschedule your visit. If you know in advance that you will be late, please contact the front
desk and we will attempt to reschedule you for the same day, when another appointment time is available. If another time is not
available on the same day, the team will work to offer an appointment on a different day. If you arrive late, please do not expect to
be seen, as we are working to ensure an optimal experience for the other patients who arrived on time.

No-show fees and cancellation fees will apply to all visits, as applicable. A no-show fee is incurred where no notice is provided for
not being able to arrive at an appointment and/or patient families arrive without correct insurance information. Cancellations
occurring within 24 hours of appointment time will incur a cancellation fee. The current no-show fee is $100 and the current
cancellation fee is $75. All fees are subject to change without notice.

Thank you in advance for your cooperation and for choosing Garden Pediatrics to serve your family.

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Childrens names

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Responsible party members name (please print)

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Responsible party members signature

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Relationship

Date

Garden Pediatrics | 101 E. Redlands Blvd. Suite 106 Redlands, CA 92373 | Office: (909) 792-8866 | Fax: (909) 792-9395