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Membership Requirements

  1. Completion of enrollment forms including a contract, billing authorization, patient history, and release of information.
  2. No enrollment fee
  3. Ongoing monthly membership fee

If you prefer to fill out your forms and bring them into the office, click below:

Submit your Infomation and Forms

Important Information to Know

  • Enter First Name *
  • Enter Last Name *
  • Enter Email Address *
  • Enter Phone Number *
  • This field is for validation purposes and should be left unchanged.
  • We do not accept insurance.
  • This is not an insurance plan.
  • We recommend you carry catastrophic insurance in case you have an accident or major injury requiring hospital care.
  • Medicare-eligible patients will need to sign a form indicating they understand that their Medicare benefits will not be used for Primary Care.
  • Our members have nearly 2/47 access to our practitioners via phone, email, and text, including after-hours appointments.
  • Members may cancel their membership at any time.
  • Members may need to seek urgent care or emergency room care from time to time at their own expense, or using their insurance.
  • We do not offer vaccinations.