Direct Primary Care
Please refer to the Direct Primary Care Membership Agreement below for a list of the specific primary care services covered under this membership plan, the associated price schedule for the cost of the membership and West Bend Family Medicine’s cancellation and refund policy for the Direct Primary Care membership program.
Additional services NOT specified in the membership agreement below must be paid for at the time the services are received. No health insurance shall be billed for any services received under this membership program.
Please fill up or download our Direct Primary Care registration form before you come in for your first visit.
Direct Primary Care Membership Agreement
Authorization for Automatic Payment
Electronic Transmission Disclosure and Acceptance