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Patient Portal

Appointment and Procedure Cancellation Policy

I understand that RONALD J. BOISEN, M.D; DARYL M. MCCLENDON, M.D. and JEFFREY W.MOLLOY, M.D. reserve the right to the following in the event that you need to reschedule:

  • $25.00 Charge for cancelled office visit without giving at least one (1) business days’ notice
  • $50.00 Charge for cancelled procedures without giving at least two (2) business days’ notice. This allows other patients to be scheduled into that appointment slot. It also makes it possible to reschedule your appointment more efficiently.

I have read, acknowledged and agree to the terms above.By typing your name below, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.