John,

Just a thought. Why not drop everybody after 9 months of inactivity. Then on the 11th month, have the receptionist send them the two 'missed' issues, plus the note as you mentioned. Then have the receptionist add a special coupoun/discount for a '6-month' style appointment because she knew they had been to buzy to come in for their regular check up. If you do this on a regular rotating basis (for all clients who go 9 months without a visit) you should see steady results.

Scott Moody