This study tested the efficacy of several interventions for reducing the rate of "no shows" to first appointments to a child psychiatry outpatient clinic. After their initial telephone contact with the clinic, patients were randomly assigned to one of four conditions: (1) a reminder telephone call, (2) an orientation letter, (3) both a telephone prompt and an orientation letter, and (4) no contact. Results indicated that any contact was significantly more likely to reduce the "no show" rate than no contact. Those who "no showed" or cancelled had to wait significantly longer for an appointment than did those who showed. Parent's primary reason for not making their appointments was that the scheduled time interfered with their work schedule. Implications of these results for improving clinic services are discussed.