Qlinimed, LLC Term and Conditions of Direct Primary Care Agreement

Membership Agreement: By signing this agreement, the patient acknowledges their understanding and acceptance of the terms and conditions outlined herein. The agreement establishes a direct primary care (DPC) relationship between the patient and the healthcare provider.

Membership Fee: The patient agrees to pay the specified membership fee on a recurring basis (monthly/annually) as outlined in the agreement. Failure to make timely payments may result in the suspension or termination of services.

Scope of Services: The healthcare provider agrees to provide comprehensive primary care services as described in the agreement. These services may include preventive care, routine check-ups, vaccinations, acute illness management, chronic disease management, and coordination of care with specialists if necessary.

Unlimited Access: The patient will have unrestricted access to the healthcare provider through various communication channels, including phone, email, or secure messaging. The provider will strive to respond to non-emergency inquiries in a timely manner, usually within 24-48 hours.

No Insurance Billing: The patient acknowledges that primary care services provided under this agreement are not billed to health insurance. The membership fee covers the cost of the included services. The patient understands the importance of maintaining separate health insurance coverage for specialized care, hospitalizations, emergencies, and other services not included in the DPC arrangement.

Ancillary Services: The agreement may specify the availability of optional ancillary services beyond primary care. These services may include discounted lab tests, medications, procedures, or other services. The patient understands that additional charges may apply for these services, as specified in the agreement.

Termination and Refunds: Either party may terminate this agreement with written notice, following any specified notice period. The patient understands that no refunds will be provided for any unused portion of the membership fee in the event of termination, except as explicitly stated in the agreement.

Privacy and Confidentiality: The healthcare provider will maintain the privacy and confidentiality of the patient’s medical information in accordance with applicable laws and regulations. The patient understands that electronic communication carries inherent risks and agrees to use secure communication methods provided by the DPC practice.

Non-Transferability: The membership and services provided under this agreement are non-transferable and limited to the named patient. The patient acknowledges that the benefits cannot be assigned or shared with other individuals.

Amendment and Modification: The agreement may be amended or modified by mutual written consent of both parties. Any changes to the agreement will be communicated to the patient in a timely manner.

Governing Law and Jurisdiction: This agreement shall be governed by and construed in accordance with the laws of the jurisdiction where the DPC practice is located. Any disputes arising from this agreement shall be subject to the exclusive jurisdiction of the courts in that jurisdiction.

By signing below, the patient confirms that his/her has read, understood, and agrees to the terms and conditions of the QliniMed, LLC Agreement.