Surgery Cancellation Policy

Our goal is to provide medical care in a timely and efficient manner. To ensure that we can accommodate all patients in need of care, we have implemented a surgery cancellation policy.

Due to the nature of surgical procedures, a specific day and time are reserved exclusively for each patient. This requires coordination of the surgeon’s schedule, operating room time, anesthesia, and hospital or surgery center staff.

If you fail to appear for your scheduled surgery or do not provide at least three business days’ notice to cancel or reschedule, a $250 cancellation fee will be charged.

Please contact our office no later than 12:00 p.m. three (3) business days prior to your scheduled surgery if you need to cancel or reschedule. You may reach us at 864-572-7001.

These charges are not billable to insurance and are the sole responsibility of the patient. The cancellation fee must be paid in full prior to rescheduling your surgery.

This fee will not apply if your surgery is cancelled or rescheduled by the hospital, surgery center, or our office due to facility availability, physician emergencies, or other circumstances beyond the patient’s control.

I have read and understand the above Surgery Cancellation Policy. I agree to comply with the terms outlined and understand that failure to do so will result in a $250 cancellation fee.

Signature of Patient or Legal Guardian – Draw your signature below using a tablet, mouse or smartphone. By clicking the Submit button at the end of this form I understand and agree that this is a legal representation of my signature.