DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • January 6th, 2020 • Oregon
This is an Agreement between Jinnah Internal Medicine, LLC (Practice), Dr. Shehzad Jinnah, M.D. (Dr. Jinnah), and (Patient or Patient’s Representative for Patient, or You or Your).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • July 8th, 2022
This Agreement is made between JD GLOVER, PLLC, a Colorado Professional Medical Limited Liability Company, doing business as GLOVER FAMILY MEDICINE (“Practice”), and You (“You” or “Patient”). Practice offers primary care services in exchange for certain fees paid by You as described in this Agreement on the terms and conditions described below.
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • August 9th, 2020 • Washington
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • March 6th, 2023 • Utah
This is an Agreement between Blake Family Medicine, PC. (Practice), a Utah Professional Corporation located at Provo, Utah, Jaren Blake, MD (Physician) in his capacity as an agent of Blake Family Medicine, PC and you, (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • December 18th, 2019 • Texas
This Direct Primary Care Patient Agreement (this “Agreement”) is entered into by and between Hometown Health PLLC, a Texas professional limited liability company (“Practice”), and you (“You” or “Patient”).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • December 12th, 2022 • New York
This is an Agreement between Buffalo Wholesome Medicine, PLLC. Buffalo Wholesome Medicine, a New York PLLC, located at 8201 Main Street Suite 8, Williamsville, New York, 14221, Maritess G. Asumen, DO and Michael F. Jaje (“Physician” or “Physicians”) in their capacity as an agent of Buffalo Wholesome Medicine, PLLC. and you,
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • August 7th, 2019 • Louisiana
This is an Agreement between aLine Health, LLC (“Practice”), a Louisiana limited liability company, located at , Dr. Mary (Mandy) Crow (“Physician”). and , (“You” or “Patient”).
DIRECT PRIMARY CARE PATIENT AGREEMENT BOZEMAN PRIMARY CARE, PLLC.Direct Primary Care Patient Agreement • March 18th, 2019 • Montana
This is an Agreement between Bozeman Primary Care, PLLC (Practice), a Montana PLLC, located at 4535 Valley Commons Dr. Ste 104, Bozeman, MT 59718, (Provider) in his capacity as an agent of Bozeman Primary Care, PLLC. and you, (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENT DUNES FAMILY CLINIC, LLCDirect Primary Care Patient Agreement • September 13th, 2020 • Indiana
This is an Agreement between Dunes Family Clinic, LLC (Practice), a State of Indiana LLC, Dr. Juana Ambriz de Williams, DNP, FNP-BC (Nurse Practitioner), in her capacity as an agent of Dunes Family Clinic LLC and you, (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • March 24th, 2021
This Agreement is made between Whole Health Family Medicine Clinic, P.C., a Colorado Professional Medical Corporation (“Practice”), and You (“You” or “Patient”). Practice offers primary care services in exchange for specific membership fees paid by You as described in this Agreement on the below terms and conditions.
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • September 28th, 2017 • Texas
This is an Agreement between Meridian Springs, Inc., (Practice), a Texas corporation located at 25420 Kuykendahl Rd Suite D700 Tomball, TX 77375-3405, Bhavana Rao, MD (Physician) in her capacity as an agent of Meridian Springs, Inc and You (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENT UPDATED TERMS AND CONDITIONS [10/2019] THRIVE ADULT PRIMARY CARE, PCDirect Primary Care Patient Agreement • September 11th, 2019 • Massachusetts
This is a Patient Care Agreement (hereinafter referred to as “Agreement”) between Thrive Adult Primary Care, PC, a Direct Primary Care practice located at 835 West Central Street, Suite 4, Franklin, Massachusetts 02038 (hereinafter referred to as “Practice”), Mary A. Medeiros, MD, MPH (hereinafter referred to as “Physician”) in her capacity as an agent of the Practice, and you (hereinafter referred to as “Patient”).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • June 29th, 2017 • North Carolina
This is an Agreement between Bethesda Integrative Medicine (Practice), a North Carolina corporation, located at 905 Halstead Blvd. Suite 29, Elizabeth City, NC 27909. Nina Lucas, MD (Physician) in her capacity as an agent of Bethesda Integrative Medicine, and you, (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • March 11th, 2020
This Agreement is made between STEPHANIE K. KRAFT, M.D., P.C., a Colorado Professional Medical Corporation (“Practice”), and You (“You” or “Patient”). Practice offers primary care services in exchange for certain fees paid by You as described in this Agreement on the terms and conditions described below.
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • October 30th, 2021
This Agreement is made between You (“The Patient”) and Ryan LaBuz D.O., PLLC, a Nevada Professional Limited Liability Corporation, doing business as Henderson Direct Primary Care and Concierge Medicine (“The Practice”). The Practice provides primary care services in exchange for certain fees paid by You in accordance with the terms and conditions below:
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • October 10th, 2018 • Mississippi
This Agreement is made on , between DPCTC, LLC (DBA TrustCare Prime), a Mississippi limited liability corporation (the “Practice”) and
DIRECT PRIMARY CARE PATIENT AGREEMENT OC SPORTS AND WELLNESSDirect Primary Care Patient Agreement • August 5th, 2019 • California
This is an Agreement between OC Sports and Wellness (Practice), a California Corporation, located at 26700 Towne Centre Dr., Ste 110 Foothill Ranch, CA 92610, Samuel E. Sunshine, M.D. (Physician) in his capacity as an agent of OC Sports and Wellness, and you, (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • December 10th, 2021 • Montana
This is an Agreement entered into on , 20 , between Eureka Family Health and Wellness, PLLC, a Montana Professional Limited Liability Company, (“the Practice”), and (“You” or “Patient”), residing at
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • August 12th, 2019 • Texas
This is an Agreement between Meridian Springs, Inc., (Practice), a Texas corporation located at 25420 Kuykendahl Rd Suite D700 Tomball, TX 77375-3405, Bhavana Rao, MD (Physician) in her capacity as an agent of Meridian Springs, Inc and You (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • January 11th, 2021 • Utah
Lotus Health, LLC (CLINIC) is a Direct-pay Primary Care practice (DPC), which delivers primary care services through its physician, Dr. Melissa Chan (Physician), at 2605 East 3300 South, Salt Lake City, Utah 84109. In exchange for certain fees, the CLINIC agrees to provide Patient with the Services described in this Agreement on the terms and conditions contained in this Agreement.
DIRECT PRIMARY CARE PATIENT AGREEMENT RIVER MILL OSTEOPATHIC, LLCDirect Primary Care Patient Agreement • September 22nd, 2021 • Maine
This is an Agreement between River Mill Osteopathic, LLC (Practice), a Maine LLC, located at 12 Priest Hill Rd Suite 2 Vassalboro, ME 04989, Joseph McCue, DO (Physician) in his capacity as an agent of River Mill Osteopathic, LLC and you, (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • February 3rd, 2022
This Agreement is made between Halcyon Health Direct Primary Care, a California Professional Medical Corporation (“Practice”), and You (“You” or “Patient”). The Practice offers family medicine in exchange for certain fees paid by You according to the terms and conditions described below.
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • October 1st, 2019 • Louisiana
This is an Agreement between aLine Health, LLC (“Practice”), a Louisiana limited liability company, located at , Dr. Mary (Mandy) Crow (“Physician”). and , (“You” or “Patient”).
DIRECT PRIMARY CARE PATIENT AGREEMENT The Schneider Organization Inc dba Concierge Health Network.Direct Primary Care Patient Agreement • January 5th, 2021 • Ohio
This is an Agreement between Concierge Health Network (Practice), a (Ohio) Corporation, located at 2835 Elm Rd NE; STE 1; Warren, Oh 44483. Dr. Brad Schneider (Physician) in his capacity as an agent of Concierge Health Network and you, (Patient).
