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 • January 4th, 2021 • Idaho
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • December 17th, 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 8th, 2022 • Georgia
This is an Agreement between Prime Direct Care (Practice), a Georgia State LLC., located at 9070 Peridot Parkway, Stockbridge GA 30281. Bridget Randolph (Nurse Practitioner) in her capacity as an agent of Prime Direct Care, LLC and you, (Patient).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • August 9th, 2020 • Washington
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • October 26th, 2020 • Oklahoma
This is an Agreement between REMEDY HEALTH, P.L.L.C. (“Practice”), an Oklahoma professional limited liability company and you, the patient (“Patient”).
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 AGREEMENT PURE FAMILY MEDICINE, PLLCDirect Primary Care Patient Agreement • April 30th, 2019 • Colorado
This is an Agreement between Pure Family Medicine, PLLC (Practice), a Colorado PLLC, located at 13402 W Coal Mine Ave, Suite 250 in Littleton Colorado, Rebecca Bub, DO (Physician) in her capacity as an agent of Pure Family Medicine, PLLC, and you (Patient).
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”).
PONTE VEDRA CONCIERGE MEDICINE DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • October 17th, 2024 • Florida
This DIRECT PRIMARY CARE PATIENT AGREEMENT (this “Agreement”) is entered into by and among RWT HEALTHCARE SERVICES, LLC, a Florida limited liability company, DBA PONTE VEDRA CONCIERGE MEDICINE (“Practice”), located at 100 Executive Way, Suite 215, Ponte Vedra Beach, FL, RICHARD TOWNSEND, M.D., an individual (“Physician”) in his capacity as an agent of Practice, and the person(s) as listed on Appendix 1, attached hereto and incorporated by this reference (“Patient”).
Washington - Direct Primary Care Patient Agreement LISSA LUBINSKI, MD, PLLCDirect Primary Care Patient Agreement • February 22nd, 2022 • Washington
This is Agreement is a “Direct Agreement” (as defined by Wash. Rev. Code § 48.150.010) between Lissa Lubinski, MD, PLLC. (Practice), a Washington PLLC located at 816 E 8th St, Port Angeles, WA 98362, Lissa Lubinski, MD (Physician) in her capacity as an agent of the Practice and you, (Patient).
Direct Primary Care Patient AgreementDirect Primary Care Patient Agreement • February 6th, 2019 • Tennessee
This is an Agreement between PATMOS EmergiClinic, Inc., (Practice), a Tennessee Corporation, located at 1231 Tusculum Blvd., Greeneville, TN 37745, Robert S. Berry, M.D. (Physician) in his capacity as an agent of PATMOS EmergiClinic, Inc. (whose name will change to DirectMD Greeneville), and (Patient). This Agreement is entered by mutual voluntary consent on , 20 .
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 AGREEMENT KARRENBAUER INTEGRATIVE FAMILY MEDICINE, PLLC.Direct Primary Care Patient Agreement • March 20th, 2022 • North Carolina
This is an Agreement between Karrenbauer Integrative Family Medicine, PLLC (Practice), a North Carolina PLLC, located at 200 Keisler Drive, Suite B, Cary, NC 27518. Camtu Nguyen Karrenbauer, D.O. (Physician) in her capacity as an agent of Karrenbauer Integrative Family Medicine, PLLC, 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 • December 5th, 2024
Thank you for choosing Reed Direct Primary Care for your healthcare needs. We regard the patient-physician relationship as of paramount importance. Good communication with your physician is at the center of our care, and this Agreement explains how we will work together.
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 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 • July 31st, 2024
This Direct Primary Care-Patient Agreement (“Agreement”) specifies the terms and conditions under which, you, the undersigned patient (“Patient”) may participate in certain private direct health programs identified in the attached Schedule A (“Services”) offered by Hansen Medical LLC dba Simplified Health DPC Practice(“Practice”). (Patient and Practice are referred to individually as “Party” or collectively as “Parties”).
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 • March 31st, 2021 • Maine
This is an Agreement between LOCAL ROOTS HEALTH CARE, PLLC (“Practice”), a Maine professional limited liability company and you, the patient (“Patient”).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • August 1st, 2019 • Oklahoma
This is an Agreement between REMEDY HEALTH, P.L.L.C. (“Practice”), an Oklahoma professional limited liability company, located at 5014 East 101st Street, Suite 200, Tulsa, Oklahoma 74137, [*Physician Name](“Physician”) in his capacity as an agent of Remedy Health, P.L.L.C. and you, [*Patient Name], (“Patient”).
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • September 15th, 2021
This is an Agreement between you (Patient) and Rodney R Story, MD, Timothy Matthew McCabe, MD, Lisa Halpert FNP, and/or Andrew Becker PA (Provider) in their capacity as an agent of Story Family Medicine, Inc. Story Family Medicine, Inc. (SFM) (Practice), an Idaho Corporation located at 1150 Alturas Drive #101, Moscow, Idaho.
DIRECT PRIMARY CARE PATIENT AGREEMENT HARMONY FAMILY MEDICINE, P.C.Direct Primary Care Patient Agreement • October 8th, 2022 • Georgia
This is an Agreement between Harmony Family Medicine, P.C. (Practice), a Georgia professional corporation, located at 2864 E. Cherokee Drive, Suite G, Canton, GA 30115. Kathryn Neely, M.D. (Physician) in her capacity as an agent of Harmony Family Medicine,
DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • January 12th, 2021 • Texas
This is an Agreement for a direct primary care membership, entered into on date which this agreement is executed by both parties, between Impact Health Direct Primary Care, PLLC (Practice, Us or We), and Patient, Member or You.
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.
DR. JAMES V. BONDS DIRECT PRIMARY CARE PATIENT AGREEMENTDirect Primary Care Patient Agreement • November 6th, 2022 • Texas
In exchange for certain fees paid by Patient in accordance with this Agreement, the Practice, through James V. Bonds, M.D. (“Physician”) and its clinical and administrative staff, agrees to provide Patient with the “Services,” as defined below, pursuant to the terms and conditions set forth in this Agreement.
