IMPORTANT PATIENT NOTICE

Dear Patients & Family,

 

Thank you for trusting Amphyst Behavioral Health with your care. It is a privilege to partner with you, and we sincerely appreciate the opportunity to support your mental health and wellness.

 

Although administrative, late-cancellation, and no-show fees are included in our Patient Service Agreement, Amphyst Behavioral Health has historically waived these fees. Beginning January 1, 2027, the following fees will be implemented and enforced.

 

FORM AND LETTER FEES

Completion of forms and preparation of administrative letters outside of routine clinical documentation may require additional provider and staff time. Effective January 1, 2027, a fee of $25.00 to $75.00 may apply for completion of external forms and administrative letters, depending on the complexity and time required. When applicable, patients will be informed of the fee before the form or letter is completed. Administrative fees are the responsibility of the patient and are not billed to insurance.

 

LATE CANCELLATION & NO-SHOW POLICY

We understand that plans sometimes change. When possible, please notify our office at least 24 hours before your scheduled appointment if you need to cancel or reschedule. Providing adequate notice allows us to offer the appointment time to another patient who may be waiting for care.

 

Beginning January 1, 2027, appointments that are missed, canceled, or rescheduled with less than 24 hours' notice may be subject to the following fees:

• First occurrence: $75.00

• Second and subsequent occurrences: $125.00

 

We understand that true emergencies and unexpected circumstances occur. These situations will be considered on an individual basis.

 

Late-cancellation and no-show fees are the responsibility of the patient and are not billed to insurance. Fees will be assessed only when permitted by applicable law and payer requirements.

 

Please note: This cancellation and no-show fee policy applies to psychiatric provider appointments only and does not apply to appointments scheduled with our student therapist.

 

If you have questions about these policies or whether a fee applies to a particular request, please contact our office.