Our pediatric pulmonology clinic caters to an underserved community (mostly African-American and Hispanic patients) with barriers to healthcare - such as transportation, poor literacy and language - which contribute to a baseline median “no-show” rate of 33% (January 2019 to March 2020). During the COVID-19 pandemic, families fearful of contracting the virus, missed or canceled in-person visits. Despite improved access via telemedicine patients continued to miss scheduled appointments.