Concierge Medicine Membership Agreement

Concierge Medicine Membership Agreement

The patient is aware that the costs in this section do not include the cost of prescription drugs or other treatments, procedures, services or products provided by separate independent agencies or individuals who may be prescribed or recommended by the UCM and its professionals in the treatment of the patient. The patient understands that he or she may receive one or more separate invoices for these prescription drugs and other treatments, procedures, services or products, and is fully responsible for paying these fees, and he also understands that independent agencies and individuals will have their own billing and collection practices. The UCM and its professionals may prescribe medications or other treatments, procedures, services or products related to the patient`s treatment to the patient; however, to the extent that these prescriptions or other treatments, procedures, services or products are discussed by experts, neither the UCM (if any) nor the experts are considered explicit or unspoken claims to the efficacy of a disease. The patient should contact a physician or primary care specialist for problems identified or likely to arise during receipt of member and professional services in accordance with this agreement. Professional services. The patient and his or her insured family members have 24-hour access to professional medical services provided by licensed physicians or medical assistants and/or nurses (“professionals”) through telemedicine and other applications (“Professional Services”). The patient`s consent. If the patient cannot sign, the legal agent gives consent to the treatment. For the purposes of this agreement, the term “patient” includes all patient representatives authorized to make decisions and sign the agreement on behalf of the patient. Business expenses. The patient is responsible and undertakes to bear the professional service costs that the patient and/or any covered family member receives during this agreement, based on steps that are billed annually from the date the patient first registers as a member (“Professional Fee”). The Professional Fee is calculated on the basis of the time spent on the profession, plus a proportional amount of the total overhead of the UCM for the provision of professional service.


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