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


                                                                                         Appointment  Time  
Check-­‐in  Procedures  
Form  Completion  
Insurance  Validation  

10  minutes  

                                                                                 Patient  Preparation  
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.  

 Children’s  names  







 Responsible  party  member’s  name  (please  print)  





Responsible  party  member’s  signature  













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

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