It's five in the afternoon and you are awaiting your fourth client of the day. So far it has been a productive day, but it's now 10 minutes after five and your client is late. You begin to question whether your client is on her way or if she has forgotten her appointment. You pick up the phone and call her - no answer...hmm. Your mind begins to recall the three clients you could have seen today that you had to turn away. It's now 5:30 p.m. and it's apparent your client has forgotten her appointment. Does this scenario sound familiar to you?

From time to time a client will miss a scheduled appointment. This can throw off your entire day, if you let it. More importantly, it can alter your annual income thousands of dollars. Just one "no show" per week can cost you $3,000 per year! Using these guidelines can eliminate the frustration you experience.

Create a Missed Appointment Policy - A missed appointment policy will fall within the guidelines you set for your cancellation policy. The allotted time you choose as notice to cancel an appointment will depend on how quickly you can refill the appointment. Typically, 24-hours' notice is requested to cancel an appointment, unless there is a valid emergency, such as an illness or vehicle breakdown. Some therapists can refill an appointment slot within six hours. You decide what length of time will work best for your business.

Reduce No Shows - Once the policy is in place, you'll need to let your clients know about it. There are various ways to convey your policy that will reduce missed appointments. I recommend using as many of these as possible:

• Post your written policy in your treatment or reception room. A good example would be: "Our time together is important. Unless there is an emergency, we request that you cancel your appointment 24 hours in advance, or pay the missed appointment fee in full."
• Add your written policy to your appointment cards, brochures, Web site and all other marketing materials.
• Inform clients of your policy when they are scheduling their appointments.
• Add your written policy to your health intake forms.
• Call each of your clients a day or two in advance to confirm their upcoming appointment. This reminder will surely decrease missed appointments.

Collect for No Shows - Collecting your fee for missed appointments isn't always easy. After all, no one wants to pay for services they did not receive. Respectfully, though, they should. If you prepare a missed appointment form letter in advance, all you will need to do is fill in the blanks, print it on your letterhead and mail it. Here is a sample letter:

Dear [Client]:

According to our records, you were scheduled for an appointment with me on [Date/Time of Appt.]. Because I did not see you for that schedule appointment and you did not cancel with 24 hours advance notice, which is my policy, I regret that I need to charge you for the missed appointment.

Sometimes I make mistakes and it is possible that you had a different day or time scheduled for your appointment. I also understand that emergencies arise. If either of these valid reasons are why you missed your appointment, please call me. Otherwise, I have included an addressed envelope for you to use to send a check for $60. I do appreciate your business, and thank you in advance for your understanding.

You will be surprised how many clients will just send in a check - but what about those that don't? Only you can determine how valuable your time is. If you don't have a problem with clients missing appointments, then you probably won't feel the need for a cancellation policy. If, however, your time is of value and your income is dependent on your appointments, I suggest you rid yourself of those clients and spend your energy replacing them with new clients.

By the way, as a general rule I do not charge a client for the first missed appointment. Instead, I inform them again of the policy and tell them that I will charge my full fee should it occur a second time. This courtesy rule works well for me.

Ultimately, the decision to establish and enforce a missed appointment policy is yours. When making this decision, keep in mind that your time is valuable; without a policy your income will be affected.