Application for a direct primary care agreement. If a direct provider requires a prospective direct patient to complete an application for a direct primary care agreement, the direct provider shall provide a written disclaimer on each application that informs the prospective direct patient of the direct patient’s financial rights and responsibilities and that states that the direct provider will not xxxx a health insurance carrier for primary care health services covered under the direct primary care agreement. The disclaimer shall also include the identical notice required by subsection 2, paragraph “a”, subparagraph (11).
