These policy templates are provided as a reference for practices developing their own materials and may be adapted to local needs. You should consult an attorney who is knowledgeable about the laws of the jurisdiction in which you practice before creating or using any legal documents. ​ 

Disclaimer: These sample documents do not represent AAP policy or guidelines. They are provided only as a reference for practices developing their own documentation.  

Patient Policies 

Financial Policy Samples 

These sample financial policies can be used and/or adapted to meet the needs of your practice.  

Appointment Policy Sample – Sample policy to share with families about appointments, including no-show fees, late arrivals and making appointments. 

Practice Policies and Procedures Templates 


Office Workflow  

Care Coordination 

Clinical/Population Health 


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American Academy of Pediatrics