Terms of Service

1. Purpose

This Patient Agreement (“Agreement”) outlines the policies and expectations between you (“Patient”) and [ClubMeno], a membership-based direct primary care (DPC) and telemedicine practice operated by Familee & Women’s Health PLLC (“Practice,” “we,” “our,” or “us”). By enrolling as a member, scheduling services, or otherwise engaging with the Practice, you agree to the terms below.

2. Nature of the Practice

This is a Direct Primary Care (DPC) membership practice, not an insurance plan. Your membership provides access to medical care, communication, and other listed services directly from the Practice.

Services Not Included. Membership fees do not include and do not cover laboratory testing, imaging, medications, medical devices, specialist consultations, hospital services, emergency care, or any services provided by third parties. Any such services are billed separately and are the sole responsibility of the Patient.

No Insurance Billing. The Practice does not bill insurance, Medicare, or other third-party payors. The Patient is solely responsible for payment of all fees and understands that the Practice makes no representation that any services are eligible for reimbursement. The Practice is not required to submit claims or provide billing codes unless required by law.

3. Telemedicine Consent

You consent to receive care primarily through telemedicine technologies, including audio, video, and electronic communications.

You understand:

  • The nature, benefits, and possible limitations of telemedicine.

  • That you may withdraw consent at any time by notifying the Practice in writing.

  • That telemedicine may not be appropriate for all conditions and that, if necessary, the provider may recommend in-person evaluation or referral.

4. Privacy & HIPAA

Your privacy is extremely important to us. All protected health information (PHI) is handled in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state privacy laws.

You can review our Privacy Policy for full details on how we collect, store, and protect your information.

By joining, you consent to receive electronic communications from the Practice through HIPAA-compliant platforms (including secure email, patient portal, and messaging tools).

5. Financial & Membership Policies

  • Your membership fee covers only the services explicitly described in your membership plan.

  • Membership fees are billed once a year and collected in full.

  • Fees are non-refundable once billed, except as required by law or at the Practice’s discretion.

  • Payment is required to maintain active membership status. If payment lapses, services may be paused or terminated.

  • You authorize the Practice to securely store and charge your payment method for membership fees and any additional agreed-upon services.

  • Membership auto-renews every 12 months with the option to opt out of renewal with a 15 day notice.

  • Chargebacks. Initiation of a credit card chargeback without first providing the Practice an opportunity to resolve the issue shall be considered a material breach of this Financial Policy. The Practice reserves the right to suspend or terminate services during the pendency of a chargeback and to recover administrative costs, chargeback fees, and collection expenses to the extent permitted by law.

See our Financial Policy & Refund Policy for more details.

6. Patient Responsibilities

Patients agree to:

  • Provide accurate and complete health information.

  • Update contact and payment information promptly.

  • Communicate respectfully with all Practice staff.

  • Follow recommended care plans and scheduling guidelines.

  • Immediately notify the Practice if residency changes to a different state or if you become eligible for Medicare during the term of membership. Failure to notify the Practice of these changes, or moving to an unauthorized jurisdiction, may result in the formal transition of care to another provider and the conclusion of the membership agreement.

7. Termination of Membership

Either the patient or the Practice may terminate this agreement with a 15 day written notice.

The Practice reserves the right (at its sole discretion) to discontinue its professional relationship and terminate care for any patient, subject to providing reasonable notice as required by law, upon the occurrence of any of the following events including but not limited to:

  • The patient fails to comply with the Practice’s policies

  • Engages in inappropriate or abusive behavior

  • Fails to maintain timely payment

  • Verbal abuse or threats, threatening or violent behavior to the staff/Practice

  • Providing false information or attempting to commit fraud

  • Non Compliance: Repeated failure to follow the treatment plan (e.g., not taking medication, missing appointments).

In such cases, reasonable notice will be given, and the Practice will provide resources or referrals to ensure continuity of care where appropriate.

Early Cancellation: Early cancellation does not waive or reduce the Patient’s financial obligation for the full 12-month term. Membership fees are not prorated for any reason, including early termination, non-use of services, dissatisfaction with care, or provider unavailability.

8. Limitation of Services and Limitations of Telemedicine

The Practice does not provide emergency or hospital-based care. This Agreement does not establish any obligation for the Practice to provide emergency or inpatient services. In the event of a medical emergency, patients should call 911 or proceed to the nearest emergency department.

Limitations of Telemedicine

While telemedicine allows patients to conveniently access medical care remotely, it has inherent limitations compared to in-person evaluations. By receiving care through this platform, you acknowledge and understand that:

  • Telemedicine relies on electronic communication, which may limit the clinician’s ability to perform a full physical examination.

  • Certain medical conditions may require in-person evaluation, testing, or procedures that cannot be performed virtually.

  • The provider may determine that a diagnosis or treatment plan cannot be safely established through telemedicine and recommend in-person care, referral, or diagnostic testing.

  • Telemedicine is not appropriate for emergencies or life-threatening situations. If you are experiencing chest pain, shortness of breath, suicidal thoughts, or any other urgent symptoms, you should immediately call 911 or go to your nearest emergency department.

  • Telemedicine services are provided in accordance with state licensing laws, and you must be physically located in a state where the provider is licensed at the time of your visit.

By agreeing to receive telemedicine services, you acknowledge these limitations and consent to the provider’s discretion in determining whether continued telemedicine care is appropriate for your condition.

9. Medicare Attestation

By enrolling in this membership and receiving care through Familee & Women’s Health PLLC, I acknowledge and agree to the following:

  • I affirm that I am not a current Medicare beneficiary, and I do not receive benefits under traditional Medicare (Part A or Part B) or any Medicare Advantage (Part C) plan.

  • I understand that Familee & Women’s Health PLLC and its affiliated clinicians do not participate in the Medicare program and are not enrolled as Medicare providers for purposes of billing or reimbursement.

  • I agree that I will not submit any claims to Medicare, Medicare Advantage, or any Medicare-affiliated entity for services received through this practice, and I will not request reimbursement for any portion of these fees.

  • I understand that the services provided under this agreement are private, direct-pay medical services, and are not eligible for Medicare coverage or reimbursement.

  • If I become eligible for or enroll in Medicare or a Medicare Advantage plan in the future, I agree to notify the Practice immediately so that this agreement may be reviewed, modified, or terminated as required by federal regulations.

10. Acknowledgment

By enrolling as a member, clicking “I Agree,” or submitting payment, you acknowledge that you have read and understand this Agreement, and consent to all policies referenced herein, including the:

  • Privacy Policy

  • Financial Policy

  • Refund Policy

  • Telemedicine Consent

  • Terms of Service

You may request a copy of this Agreement at any time.