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OFFICE POLICIES

Here are a few guidelines we need you to follow to help us make your child's visit go
smoothly while you are here.

  1. The children are here to have their teeth counted, cleaned, or to make them
    healthy again. Because we want to give all our attention to them, parents are
    not permitted in the treatment area. We can't give our undivided attention to
    the children if we have to share it with the parent.


  2. Because we emphasize spending quality time with each and every child, we
    schedule and see only one child at a time. Therefore, we need as much advance
    notice as possible (48 hours advance notice required) to re-schedule an
    appointment. This allows us to offer that appointment time to another person
    who may be waiting for an opening. Also if you arrive late or fail to show for a
    scheduled appointment, we reserve the right to assess a fee of $25 and/or refuse
    to reschedule.


  3. If 2 or more children are scheduled together for appointment and fail to show
    without 48 hours notice, we reserve the right to schedule separate appointments
    for them in the future.


  4. We schedule children age 5 and under in the morning. Patients 6 and up are
    scheduled in the afternoon. The younger children are better behaved in the
    morning before they are tired from playing. If behavior warrants, the doctor may
    choose to schedule an older child in the morning.


  5. If your child is sick with the flu, chickenpox, measles, has head lice, or any other
    communicable condition, please call us as soon as possible to reschedule the
    appointment. We don't want to take the chance on spreading their "germs" to
    anyone else in the office.


  6. Please be on time for your appointment. We schedule your time for the work to
    be accomplished in that appointment allotted time.


  7. Please No Food of Drinks are Permitted in Our Office Area. Please help us to keep
    our office neat and clean for everyone to enjoy.


  8. Our office payment policy is that payment in full is due at the time of service.
    Please be advised that our office is not able to extend credit. If you have
    insurance, we ask that you supply us with your insurance information prior to the
    appointment so that we may determine eligibility and the payment portion
    which will be your obligation. We also ask that you be prepared for any balance
    due at that appointment. Except for the amount to be paid by the insurance
    company, you will be responsible for the balance at that appointment. Any
    unpaid balance will be subject to interest and any collection fees or court costs
    incurred as the result of non-payment.


Please sign below to indicate that you agree and understand the above office policies.



Signature______________________________


Date_________________________________

Dr. Suzi | 210 NW 75th Drive | Gainesville, FL 32607
Phone: 352-331-7213 | Fax Number : 352-336-6903 | Business Hours: Monday-Thursday 9am-5pm


Dr. Suzi | NE 25th Avenue | Ocala, FL
Phone: 352 622-1100 | Fax Number : 352-336-6903 | Business Hours: Monday-Thursday 9am-5pm