We charge a deposit only where a no-show hurts most, the long new-patient visits, and we frame it as reserving the hour rather than policing the person. The deposit applies in full to the visit, and the booking message says plainly that this time is held for them alone, which turns the same dollar amount from a threat into a courtesy.
My fear was scaring off exactly the new clients we wanted, so we tracked it instead of guessing. Of the first 90 new-patient bookings under the policy, 3 people pushed back, and none walked away once the front desk explained it in person-language: your hour is protected, and the deposit simply confirms you want it. New-patient no-shows fell to roughly a third of what they had been, and the revenue question ended there.
The confirmation side matters as much as the deposit. Our reminder offers a reschedule path in the same breath as the confirmation, because the goal is not punishing absence, it is moving the slot while someone else can still use it. A patient who reschedules three days out is a kept relationship and a filled hour. The same patient cornered by a rigid policy becomes a quiet cancellation of the whole relationship.
The principle I would hand any appointment business: attach cost to the scarce thing, which is the reserved time, and attach ease to everything else. People accept paying to hold what is being held for them. What they refuse is feeling pre-accused of a failure they have not committed.