Patients who do not call to cancel their appointments prior to the scheduled appointment time, and do not show up for their appointments three times in a 12-month period, or five times for children under the age 18, will only be allowed to schedule Same Day Appointments (SDA).  For each appointment that the patient “no calls, no shows”, the patient or parent will receive a letter informing them of the policy and the potential outcome of their actions.  If the patient should continue to miss their Same Day Appointments without calling three times in a 12-month period for adults, five times for children under the age 18, the patient may be reviewed by the Medical Director, Primary Care Provider and Executive Director to decide if they should be discharged.. Patients who are limited to SDA and keep all their appointments for a one year period may ask that their SDA status be lifted. In addition, a provider will be allowed to appeal SDA status on behalf of their patient at any point in the process.