List of Forms and Documents
You'll need to draft these legal documents to operate your direct primary care practice.
Prefer paper?
Forms
All the forms and contracts you'll need to run your practice
Patient Agreement
Visit the websites of practices in your area (find them using the DPC Frontier Mapper). Some have a link to their Patient Agreements linked at the bottom of their websites. See some examples fromVintage DPC, Hampton DPC, and Inspire Health.
Release of Records form
See sample here.
Billing Authorization form
If you're accepting patient billing information on paper, you'll need an authorization form. If patients provide billing information online via your billing vendor, this won't be necessary. See a sample credit/debit authorization form and a sample ACH form here.
Patient History form
See sample here.
If hiring: Employee Contract
Optionally, run everything by a lawyer
There are some very good sample documents available for free online or on the websites of established DPC practices. If you want to be 100% sure that your documents are airtight, run them by a lawyer familiar with medical law/regulation, or DPC in particular. Many practices use Luanne Leeds who specializes in helping DPC practices.
The above content is not legal or medical advice.
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