This research reports the effectiveness of three interventions utilized to reduce broken appointments at a hospital dental clinic. Subjects in this study were 306 outpatients receiving dental care at Harborview Medical Center in Seattle. Prior to this investigation the clinic was not using any confirmation strategy; the no show rate was 30.2 percent (N=169). The first intervention was the traditional clinic-initiated phone reminder one day prior to the appointment; the second intervention made use of a mailed reminder, requesting patient-initiated confirmation by phone; and the third gave the same postcard reminder to the patient at the appointment desk, also requesting telephone confirmation. The two patient-initiated strategies were considered more consistent than the traditional phone reminders with the concept of patient responsibility for his own health care. The broken appointment rate for the phone reminder group was 23.5 percent, while for the postcard and the appointment card groups, the rates were 21.2 percent and 11.5 percent respectively. The rate for the appointment card group differed significantly from the phone reminder group and also from the baseline sample.