My No Show Policy Template & Fee for Therapists [Prevents No Shows]
Takeaway: As a therapist, your time is valuable. Having a clear no-show policy is essential to setting (and maintaining) boundaries around your time and energy. In this post, I’ll share my no show policy template that you can customize to fit your practice’s needs. Plus, I share my top tips for enforcing your policy, including what to say when your therapy clients don't show up.
Table of contents
Creating your no show policy
Creating a no show policy with save you so much time. Instead of scrambling to figure out what to do in that inevitable moment when a patient misses their session, you'll be totally prepared. In this blog, I'll share with you why you need a no show policy, what to include in your policy, and and a template you can use and customize for your own private practice.
I've heard many therapists say, "My clients are good. They come regularly. I don't need a policy like this." While this may be true, it totally misses the point of why we put these policies in place.
Cancellation and no show policies aren't punishments for "bad patients." They are standard business practices that apply to all clients and ensure your business runs in a way that works well for you. A solid, clear policy will reduce missed appointments, save you time, and ensure you're not losing hundreds or even thousands of dollars unexpectedly.
You'll prevent wasting time in limbo waiting for your client.
When a patient misses an appointment without showing up, you don't know if they're coming (of course).
Chances are you've spent more than a few hours in your office going back and forth between your room and the waiting room, constantly checking your phone to see if your client has sent you a note. Or maybe you're scrambling online signing on and off of your video call, worried that you're in the wrong Zoom room or somehow got the time wrong.
My no show policy will ensure that you're never stuck in limbo waiting for a patient again.
You'll increase and stabilize your private practice income.
No shows and late cancellations can cost you hundreds or thousands of dollars per month. Sudden dips or wild fluctuations in income are incredibly stressful and take a toll on therapists. This wear and tear is one of the reasons why therapists leave the field at an alarming rate. Stabilizing your income in one step you can take to make your career more sustainable.
You'll create a more predictable weekly schedule.
It's hard to plan your personal life when patients don't show up or cancel at the last minute. You know the frustration of saying no to a dinner with friends, a work out class you've been dying to go to, or time with your children only to have your scheduled client miss their appointment without warning.
Without advanced notice of when we're working, we can't plan our lives and end up missing out on opportunities. Though you can stomach this a few times, it's not long before you realize you need a policy for this.
P.S. Want guidance on crafting your ideal schedule? Check out this blog post for sample schedules and tips on calculating how many clients to see in a week.
You'll increase client attendance and improve therapeutic outcomes.
When a person cancels (or doesn't show up at all), it doesn't just impact the provider—it also impacts the client's own therapeutic process. In fact, this literature review shows that no shows in a medical setting are correlated with longer wait times for appointments, disruptions in continuity of care, and even higher rates of ER admissions.
While your therapy practice isn't a medical practice, your clients can still experience negative effects from missed appointments.
Having a no show policy will help patients avoid missed appointments and increase consistency in attendance. While engaging in the therapy process is ultimately each patient's choice, a clear (and consistently enforced) cancellation policy can help ambivalent patients become more committed.
You'll reduce your admin time.
No shows and late cancels mean more time communicating with clients outside of session time to reschedule their appointment. Doing outreach in your unpaid time cuts down on time that could be spent seeing other clients, spending time with friends, or doing something for yourself.
The fact is, clients cancel and no show from time to time. Even if that happens rarely, it's much better to have a policy in place ahead of time. Don't wait till you're so frustrated you have to create a no show policy.
In a private practice, our preferences for how we'd like clients to engage with us become policies. Hoping your clients won't cancel or arrive late to their appointments is not a good strategy. Responsible private practice owners take the time to craft thoughtful policies that reinforce the therapists' own enjoyment of their work.
A good no show policy sets your clients up for success. Your policy should be a reflection not just of your clinical perspective but of how you want to be treated by your clients. From the first appointment, this sets a tone that you're committed to the therapy process and that you expect your clients to be as well.
Take the time to make sure clients understand your policy and what happens if they miss an appointment without communicating. In other words, don't just take their electronic signature (or physical signature on a paper form) as their consent to your policy. Having a clear, open discussion about your policy allows clients to make informed decisions about their care and gives you the reassurance that you're both on the same page.
Here are a few key components that I highly recommend including in your no show policy.
What clients should do if they're running late
Let clients know what to do if they know they are running late to a session. Take some time to reflect on how clients would ideally engage with you under these circumstances. How would you like them to contact you to inform you that they're running late? How long are you willing to wait for a client?
What clients should do if they need to cancel last minute
Let your client know how they should contact you. Decide whether or not rescheduling or making up the session is an option. Does the reason why they're canceling make a difference as to whether or not they'll pay the missed session fee? If so, get really clear with yourself about what circumstances dictate whether a client pays for a missed session.
What happens if clients no call, no show
Create an SOP (standard operating procedure) for when a client has missed a session and hasn't contacted you. Consider how many missed appointments you allow before you discharge the client from treatment. Decide how will you bill the client for missed appointments.
Missed appointment fee
Make sure to include the details of when clients are responsible for the missed appointment fee, including when payment is due and how it is collected. I recommend limiting the number of appointments a client can cancel for free. Learn all about my limited cancellation policy template.
Take the time to think through these various situations and be honest with yourself about your preferences and what you need to feel respected. Remember that this policy is not at attempt to "punish bad clients" but to set you and your clients up for success.
Now that you've realized what you need to manage your practice effectively, it's time to take those preferences and translate them into your no show policy form. Use my no show policy template and customize it to your own needs. You'll find that my policies include a lot of details without over-explaining. This policy is based on my limited cancellation policy template which you can read more about here.
Customize away! All required customizations are highlighted in pink.
Advanced and late cancellations
I ask that you give me as much advance notice as possible when canceling a session. Please let me know in session or via email/text/phone whenever you need to cancel.
You may cancel up to 4 sessions per calendar year without paying the session fee as long as you provide a week's notice. Sessions cancelled with less than [one week's/72hrs/48hrs/24hrs notice] will be considered late cancellations and you will charged your session fee at the time of your regularly scheduled appointment.
Running late
Please let me know via email/text/phone if you will be more than 10 minutes late for a session. It is not a problem for you to run late occasionally and I am happy to wait for you to arrive as long as I know when to expect you.
If I have not heard from you within 10 minutes of our session start time, I will assume that something may have happened and you are not coming to your session. I may choose to move on with my time for the remainder of the hour. This will be considered a late cancellation and you will automatically billed for the session/payment is due via [your payment processor here].
Multiple no call now shows
If you no call, no show two weeks in a row and I haven't heard from you, I will take it that you no longer want to continue therapy and you will be discharged from my caseload. I understand that there are many reasons why patients sometimes have a hard time coming to therapy consistently. If that is the case, I urge you to speak with me about it so we can work together to address your concerns.
Exceptions
I do not offer free late cancellations for any reason. You may cancel up to 4 times per year without paying the session fee when you cancel more than one week in advance.
OR
I offer up to one/two/three/four free late cancellations due to [highly specific reasons]. If you need to cancel for one of these reasons with less than one week's/72hrs/48hrs/24hrs notice, you will not be charged the session fee. Late cancellations beyond the allotted one/two/three/four free late cancellations, will be charged.
Your clients deserve to know exactly what they can expect and to be given honest and clear guidance on how to engage with you and the work. Strive to be clear and exact with your language in the moments when you need to uphold your now-show policy. This will make it much easier.
Having the best no show policy in the world won't do you any good if you don't uphold it. Upholding your no show policy consistently avoids the common pitfall of accidentally using it as a punishment or reward.
Your no show and cancellation policies are a way to encourage consistency. But more than that, they ensure that your business is sustainable and supports your well-being.
Therefore, when discussing it with clients, try to stay neutral and clear. Avoid apologizing or explaining. And remember when you aren't consistent, you create confusion for your clients and end up creating unhelpful dynamics you'll have to work to undo later.
Below I'll share my tips for sharing your policy with clients and what to say when a patient no shows.
Discussing your no show policy with clients
As a trained therapist, you are great at talking about challenging topics. Yet for many reasons, you might shy away from sharing your no show policy with your patients. In this section, I'll share tips for how to talk with your clients about your no show policy without going down a rabbit hole of over-explaining or justifying.
Assume your patients will be amenable to the policy.
Whether you realize it or not, you have assumptions about how your patients will react to this news. If you're like most therapists, you assume your clients will be unhappy and you may even lose them.
But you might be surprised! I have found that most clients are willing to accept my cancellation policy and it rarely causes any grief between us. In some cases, my clients were even happy that it was in place because it helped create accountability for them.
Remember that it's okay for clients to disagree with you.
Being a good therapist doesn't mean your clients always need to agree with you. They are allowed to have different preferences. Nonetheless, you are responsible for holding the container and setting policies.
The truth is that your no show policy is a reflection of your own personal preferences and (hopefully) the math you when you set your fee. (Oh! You haven't done the math yet? Here, let me help you with that. Get my fee calculator.)
Explaining all the reasons why you created this policy would not be appropriate or helpful. It's enough to say, "This is the policy that allows me to work well in my practice and provide a high-quality service to my clients." This truth is enough.
Know that your clients have a choice.
We often worry that we're 'making' our clients do something when we raise our fees or update the cancellation policy. It's so important to view our clients and potential clients as empowered humans who can make choices for themselves. You are allowed to reevaluate your boundaries and update your policies. And you should!
Though this might be scary at first, know that many brave therapists have gone before and survived. Not only that, they've also reaped the benefits of increased income, a more stable work week, and private practice filled with good-fit clients.
Addressing no shows: What to say to no show clients in therapy
Even when you're clear about your no-show policy from the beginning, clients may still miss sessions without warning. Here are my recommendations for how to address no-shows when they happen.
Get neutral
You may have lots of feelings about creating a boundary with your clients about their therapy attendance, but as much as possible, leave your own feelings of weirdness at the door. This may mean doing some journaling, talking to a trusted friend, or working with a business coach like myself to help you work with any part of you that may be feeling guilty, unworthy, or scared.
The first email/contact script
When you first reach out to a client when they've no call, no showed, I suggest something like this:
"Hey, *your client's name*. I missed you at your therapy session today and I hope you're alright. When you get this message, please just write me back to let me know if you're okay and what happened. Per my cancellation policy, your fee is due/your fee was automatically charged. Let me know if you'd like to find another time to meet this week (as long as that is something you offer). Otherwise, I'll expect to see you next week at your regularly scheduled session."
Use this email template next time a client misses an appointment if you're not sure what to say.
Think twice before making exceptions
It's normal for clients to test this boundary even after you've clearly stated your cancellation and no show policy. Though allowing an exception to your policy might feel good to the client and like a relief to you in the moment, this typically only creates confusion and headaches in the future.
If a client asks for an exception and you want to uphold your policy, reiterate your policy while meeting them therapeutically in their frustration or whatever emotion or concern is arising.
Get support creating (and implementing) policies that align with your needs as a private practice therapist
Next to raising your fee, upholding your cancellation policy is the scariest thing private practice therapists have to do, and most of us have almost no good models for how to do it. Hopefully, this blog post has helped you feel more confident.
If you're finding that you're still struggling to define your policy share it with clients, or uphold it when the time comes, it's time to start working with a business coach.
I have been right where you are. I've had the scary conversations, gotten the pushback, and found the clients who love working with me in my practice. I can help you build yours. Whether it's in my program, Liberated Business, one on one coaching, or CEO Days, I help therapists gain the confidence to put themselves first when making important business decisions and grow their practice in strategic, hustle-free ways.
