Common Contracts

DIRECT PRIMARY CARE PATIENT MEMBERSHIP AGREEMENT

Direct Primary Care Patient Membership Agreement • March 25th, 2021 • Indiana

• Contract Type
  Direct Primary Care Patient Membership Agreement
• Filed
  March 25th, 2021
• Jurisdiction
  Indiana

This is an Agreement between Convenient Healthcare VA, LLC (Practice), a State of Virginia, Charlene Bell, FNP-C (Nurse Practitioner), in her capacity as an agent of Convenient Healthcare VA, LLC and you, (Patient).