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Patient Disclosures:
Appointment Cancellations/ Missed Appointments
Scheduled appointments are reserved especially for you. If an appointment is missed or cancelled with less than one
business day notice, you will be charged $50.00 for that appointment. Repeatedly not showing for appointments could
result in discontinuing further care.
Pregnancy
Many prescription drugs are potentially toxic to the fetus. If you are treated with medications here, please let your
doctor know if at any time you think you may be pregnant or if you are not properly protected.
Driving and Operating Machinery
Many psychiatric medications can affect your level of alertness or your speed of reflexes. Please exercise extreme
caution when driving or operating machinery if you have recently been started on a new medication or if your dose was recently changed.
Non FDA Approved Medications
Many psychiatric medications are not approved by the FDA to be used in children and adolescents.
Also the medications may not be FDA approved for usage in that particular psychiatric illness. These medications may still be
used secondary to the doctor's experience and usage in the community.
Returned Checks
There is a $50.00 fee for any returned checks
Insurance Billing
It is our policy to bill insurance carriers for our patients. Patients/Responsible Parties are responsible for all charges whether or not
they are covered by your insurance including deductible and co-payments when applicable.
Payment Policy
Dr. Mac requires payment for in-office services at the time services are rendered for all services not covered by insurance.
Payment may be made by cash, personal check, or credit card. Telephonic appointments must be prepaid by personal check. As
patients are expected to maintain a zero balance our office does not send patient statements on a regular basis.
Unpaid accounts over 90 days old are routinely reviewed for submission to our collection agency.
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