Sample Cancellation Policy Template for Therapists [2024 Update]
Use my customizable template.
As a therapist, it's crucial to have a clear cancellation policy.
This helps clients understand the expectations and consequences of missing appointments. While many therapists agree with this in theory, we often struggle to uphold it.
In this post, I'll cover everything you need to know about cancellation policies: why you need one, what to include, and how to follow through with it. Plus, I share my cancellation policy script for you to customize and use in your own practice.
Plus, you'll get a customizable cancellation policy template to add to your informed consent document. You'll also learn how to develop clear criteria for enforcing it in a way that aligns with your values and supports your ideal clients.
P.S. Are you unclear about your fees in the first place? Get free access to my fee calculator that helps you know how much money you can make AND vacation you can take.
Everything you need to know about cancellation policies as a therapist
A solid cancellation policy is absolutely crucial in helping you know how to set your fee so you can hit your income goals. Instituting a limited or 'no' cancellation policy is new for most therapists, and it may feel hard. You probably worry about clients getting mad at you. You might doubt whether anyone would agree to work with you if you were to actually enforce this policy.
I can tell you that though those fears are common, they are absolutely not true. Though some clients may not agree to those terms and will seek services elsewhere, there are plenty that will. And building a practice that feels good to you, one that you can sustain, is our number one goal.
You may worry about what to do if your client has an important medical appointment, unavoidable emergency, or serious or contagious illness. I'll share cancellation policy examples that you can customize for your practice.
My experience with cancellation policies
The whole purpose of a no show policy is not to punish clients who miss sessions, but to create stability for you as a business owner so that you can enjoy your life and show up for your clients in the best way possible. That's easy to say, but when push comes to shove, it can still be hard to uphold your no show policy when your 'favorite' client has an 'emergency.' I'm going to be totally honest with you. There was one time I didn't do this. A client of mine who showed up reliably didn't come to session because of an emergency with their pet. Weirdly, I let it slide. This wasn't the biggest 'emergency' a client of mine had faced. And all the years later I can't quite recall how I justified not upholding that policy. But afterwards I realized my error, that it wasn't fair to myself or to my other clients, and decided I wouldn't do that again. Months later when that client needed to cancel again, I upheld my policy. My client was clearly confused wondering why I didn't let them off this time when I did just months earlier. I realized I had put myself in a position where emergencies were up for debate, rather than just havinga clear policy where a no show was a no show regardless of the reason for it.
Why a therapist cancellation policy is important
Most therapists want their clients to come consistently but few create policies that encourage that. Why do therapists want this? Therapists want consistent schedules and reliable income. We also want clients to receive the benefits that are only possible with regular therapy. Clear policies are necessary to create your ideal counseling practice and ensure that clients get the most out of your work together.
Private practice therapists typically require 24-hour notice for clients to avoid a cancellation fee. Even though this is typical, it's a terrible policy for therapists. This kind of policy leads to an increase in missed sessions, no-shows, and schedule adjustments.
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24 hours notice is simply not enough time to fill that time slot and the result is loss of income for the therapist. Even with adequate notice and a waiting list of potential clients, it's not ethically appropriate to schedule a new client you couldn't keep seeing. Without limitations on how clients can cancel, therapists can't predict their schedules or incomes.
While this might seem harmless at first, it eventually leads to hours of admin work on your end. Plus, it creates stress due to an unpredictable loss of income. It's okay if your clients need to cancel from time to time, but the financial burden of that shouldn't fall on your business.
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In a solo therapy practice, you only have so much time reserved exclusively for seeing clients. The rest of your time is dedicated to admin work like session and clinical notes, making referrals, and continuing education—all of which is unpaid. It's important that every hour you've allotted to seeing clients is one in which you are being compensated. This requires that every client pays for their scheduled appointment.
This is the reality of the private practice business model. As the service provider and business owner, it's your job to set the tone and expectations of how clients will work with you. When you don't do this, you compromise your ability to continue your work in the field. You also create opportunities for resentment, which could harm the therapeutic relationship.
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Nearly every therapist has some cancellation policy in their informed consent, but not everyone enforces it. Therapists feel guilty, fear clients getting mad, or lack the confidence to enforce the policy. While you may think you're doing your client a favor, what you're actually doing is confusing them.
And if you pay really close attention, you may find that you don't apply your cancellation policy the same way with every client. Are you rewarding 'good' clients by allowing them to not pay for their missed session? If you feel intimidated by a client, do you waive the requirement that they give advanced notice to avoid a no-show fee?
Having a clear, consistent cancellation policy ensures a sustainable practice and therapeutic relationship. It also helps prevent unexpected financial loss and stress. It's okay if your clients need to cancel from time to time, but the financial burden of that shouldn't fall on your business.
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At a rate of $225 per session, 2 cancellations per month results in $5,400 of lost income per year. That could be 4 to 6 months of what it costs to rent a full time psychotherapy office!
But let's say you have a large caseload where clients pay much lower fees. A client who pays $80 cancels because they got sick. Another client who pays $130 wanted to go on vacation for 2 weeks. You knew about this ahead of time, but they're coming back after those two weeks so you don't fill that spot. A third client who pay $110 scheduled a dentist appointment on the day they usually meet with you. You're happy for the time off, but you just lost $320. That's about how much you spend on groceries for you and your family each week and if your caseload was just making enough to cover your expenses, you're going to feel the impact of that missing $320.
Based on a stroll through Reddit, therapists report 1-7 cancellations per week! A therapist with an average fee of $170 and an average of 3 cancellations per week is loosing $26,520 per year! You can probably think of a lot of things you'd like to do with that money. And if you can't, I'll help you. With $26,520 you could…
1. Go on 11 international vacations,
2. Buy a brand new car, or
3. Make a huge contribution to your retirement and 401k accounts to catch up on all those years of underearning.
What to include in your cancellation policy
Your cancellation policy should lay out exactly what happens when a client cancels. Below you'll find each important element in an effective cancellation policy. Add these to your client agreement!
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Share that you have a limited number of spots on your caseload. Explain that you cannot fill any missed appointments temporarily or with new clients. Each client takes one of the limited appointment times on your caseload. Clients cannot take more than one of these. Therefore, cancellations are limited and late cancellations will result in fees.
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Share that you have a limited number of spots on your caseload. Explain that you cannot fill any missed appointments temporarily or with new clients. Each client takes one of the limited appointment times on your caseload. Clients cannot take more than one of these. Therefore, cancellations are limited and late cancellations will result in fees.
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Even if you limit the total number of free cancellations, you still don't want last-minute cancellations. I chose to require one week's notice for cancellations in order for clients to use one of their allotted four free cancellations. And if they canceled anytime less than a week in advance, they had to pay the same cancellation fee. Clients could cancel an appointment for any reason with no fee as long as they still had one of their 4 "freebies" available and gave me a week's notice.
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Rescheduling clients can eat into a lot of your time and can be frustrating if it happens frequently. You will decide whether you allow clients who need to cancel to reschedule their appointments to another other time slot. In my cancellation policy template below, you'll see how I handled rescheduled appointments in my practice.
When you set a limit on how many appointment times a client can cancel, it doesn't matter why clients choose to cancel appointments. They're allowed to cancel to go on vacation just as easily as they would cancel due to the sudden onset of an illness. There are no exceptions for emergencies, doctor appointments, vacations, or unexpected work obligations. This gets you out of the position of having to decide what 'counts' as an emergency or not.
Customizable cancellation policy template for therapists
Use my customizable template.
After working in various settings for over a decade, I developed a document called "How to get the most out of your therapy." This guide taught clients how to engage with the therapy, as well as with me and my business. By following these guidelines, clients were able to get the most out of our work together. If you use the cancellation policy examples below, you'll have fewer no-shows, rescheduled sessions, and lost income.
Customize this template by choosing either a 'limited' or 'no' cancellation policy. You'll also need to determine your late cancellation timeframe and clarify your reschedule policy. Check out my private practice design tool, The Bad Therapist® Magic Sheets, for guidance on how to do this. Now all that's left is to tell your clients!
Customize away! All required customizations are underlined in pink.
You will benefit most from therapy when you attend every week. There are many different styles of therapy that may be effective, and it is important that you find the right fit for you. I offer depth work, which is most effective with regular sessions. Therefore, I require a commitment from clients to attend weekly therapy.
I understand that our schedules change, and there may be times you simply cannot make it in for your session. You may cancel up to 4 sessions per calendar year without paying the session fee as long as you provide a week's notice. If you cancel any sessions beyond those 4 for any reason, you will be responsible for the cancellation fee.
I ask that you give me as much advance notice as possible when canceling a session. Late cancellations are sessions canceled less than a week before the scheduled session time. You will be responsible for the full fee. These would not count toward your 4 free cancellations. You are welcome to explore options for rescheduling or making up a session.
If you are traveling, ill, or otherwise can’t make it to an in-person session, teletherapy may also be an option. If you are not able to attend or find a mutual time to reschedule the session, you are responsible for the full fee. Payment is due at the time of your regularly scheduled session. If I am not able to attend a session, you will NOT be charged the fee.
Scripts for upholding your cancellation policy
Check to see if your client has read your whole informed consent, including your cancellation policy. Reiterate that they must cancel within a certain number of days to avoid a late fee. Also, remind them that they only have a certain number of free missed appointments per year.
What if I have an unavoidable emergency, illness, or important medical appointment?
“Of course, if you can't come in due to a contagious illness or an emergency of some kind, that's okay. But due to the nature of this work, the limited number of spots on my caseload, and the inability to fill that spot temporarily with a new client, I can only allow 4 free cancellations in a year for each client.”
I had plans to travel for two months/be out of the country/just want to take weeks off. Do I really have to pay for an appointment cancellation?
“Yes. You're allowed to cancel appointments for any reason at all whether it's due to an emergency, work obligation, or fun opportunity. You receive 4 free cancellations each year. Any missed appointments beyond that are your financial responsibility.
If you're traveling, you are still welcome to meet with me via teletherapy. Plus, with advanced notice of your travel, we may be able to adjust our meeting date and time. If you're ill but still well enough to engage, please do not attend the session in person.
Instead, we can meet via teletherapy.”
This policy seems really unusual and extreme. Why did you make your policy like this?
“The Bad Therapist® made me do it!” 😜 JK, here's what to say.
“You're right, this policy is unusual. Yet, more and more therapists are beginning to adopt policies like this every day. When I was setting up my practice, I gave a lot of thought to what policies and practices I needed. These policies help me sustain the practice and myself. They also allow me to show up for our work together in the best way possible.
“I also believe that regular therapy will give you the best bang for your buck for the time, energy, and financial resources you're putting in. This policy isn't going to work for every client and some choose to seek services elsewhere. But for clients in my practice, this is what's required for us to work together.”
You seem really serious about this. Are you really going to make me pay if I miss more than 4 times?
“Yes, if you miss more than 4 sessions or have a late cancellation, you must pay the fee. Again, I have been very thoughtful and intentional in crafting this policy. I try to do my very best to say what I mean and mean what I say. It wouldn't make sense for me to tell you this is what the policy is and then not follow through. That could be confusing and not good for our relationship.”
As a rule, I try not to justify my private practice policies to clients. It's not their responsibility to give a shit about how and why I take care of myself. But you better believe it is mine! Instead, I try to keep it simple, reiterate the policy, and make sure they understand and can agree if we are to move forward with working together.
Working with a coach for therapists can empower you to enforce your boundaries.
By now you know how helpful this policy is to creating stability and making sure you don't lose money when clients cancel. Even so, left to your own devices you may struggle to actually take action and put your new policy into place.
That's where business coaching for therapists comes in. Having a guide, especially someone who has been right where you are now, can help you stick with your plan so you can build the practice you love.
Whether it's in my program, Liberated Business, or one on one coaching, I help therapists gain the confidence to put themselves first when making important business decisions. Besides earning more money and working less, my clients report a huge shift in their confidence when talking to clients. They also learn how to market their practices to attract and sign their ideal clients.
