Membership Agreement

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SimpleMedVisits Membership Agreement

1.Patient-Clinician RelationshipBy your signature, you acknowledge that you are voluntarily becoming a patient of SimpleMedVisits and its medical group or affiliated clinician. As a SimpleMedVisits patient, those services described in Section 2 below will be made available to you pursuant to the terms of this Membership Agreement. 

2.SimpleMedVisits ServicesHealth Care Services: As a patient, you are eligible to receive a set of primary care, preventive care, and urgent care services as offered by your individual clinician from among those listed in our Detailed Service List (attached below and also available at SimpleMedVisits WEBSITE or at your SimpleMedVisits clinic location). You are also eligible to receive 24/7 mobile phone and emailaccess. During the term of this Agreement, the Health Care Services provided by SimpleMedVisits may be subject to change bySimpleMedVisits from time to time. Such changes, if any, shall be reflected on the Detailed Service List.If you have a pre-existing medical condition, please contact us first to learn how you may benefit from SimpleMedVisits services.Pre-existing medical conditions do not disqualify you from enrolling in SimpleMedVisits service.By entering into this Membership Agreement, you acknowledge that SimpleMedVisits does not provide healthinsurance coverage and that this is not a contract for insurance. SimpleMedVisits provides only the Health Care Servicesspecifically described herein and additional costs may be incurred for laboratory, medical imaging, surgery, specialist care, emergency department visits, and hospitalization required outside of SimpleMedVisit’s services. SimpleMedVisitsencourages you to combine SimpleMedVisits membership with appropriate health insurance coverage.

3.Fees and PaymentSimpleMedVisits charges the Comprehensive Monthly Fee listed below per Member to include all Covered Healthcare Services included on the Detailed Services List. 

   ●Member aged 18-65 years old: $85 per month

A 10% discount will be applied to the total fee for annually pre-paid memberships. 5% discount will be applied if paid quarterly or semi annually to the total fee. With a minimum initial enrollment period of 2 month. 

SimpleMedVisits also charges a one-time $50 registration fee payable with your first monthly payment per individual. Max fee of $75 per Family. 

Payment transactions declined due to insufficient funds or expired cards will result in an additional fee of $50 and failure to comply with payment terms may result in termination of my membership. Services will not be rendered for patients with past due accounts. 

Most, but not all, of the services described above in Section 2, are covered by the Comprehensive Monthly Fee, subject to the limitations set forth in this Membership Agreement. However: 

● Per IRS guidance, if you participate in a high-deductible health plan with a health savings account (HSA) feature, you may be required to pay on a fee-for-service basis for certain primary care, non-preventive care and urgent care services until such time as your deductible has been satisfied. If you don’t pay on a fee-for-service basis for these services, it is possible you may lose your ability to contribute to your HSA during your membership. Please consult your attorney or financial adviser. SimpleMedVisits hereby disclaims any responsibility or liability with respect to your decisions made thereto. ● Some Health Care Services provided by SimpleMedVisits are not covered by the Comprehensive Monthly Fee (Non- 

Covered Health Care Services). The SimpleMedVisits fee schedule for these services will be provided to you upon your request. SimpleMedVisits may amend the fee schedule from time to time in its sole and absolute discretion and without prior notice. ● If you request and receive a Non-Covered Health Care Service, Payment at Time of Service is Due in Full . We accept cash, credit or debit card payments. ● We do not submit claims to insurance companies, government programs, or any third-party payers. All Non-Covered Health Care Services provided by SimpleMedVisits are billed directly to the patient. ● You agree not to submit any claims to any third party payer or any government health care program for Covered Services rendered by SimpleMedVisits to you under this Agreement. ● All Fees paid are non-refundable. This includes all Fees that may have been paid whether such were paid on a monthly or annual basis.  

● Email and texts can be circulated, forwarded, stored electronically and on paper, and broadcast to unintended recipients.

● Email and text senders can readily misaddress an email or text.

● Email and texts can be intercepted, altered, forwarded or used without authorization or detection.

● Emails and texts may not be secure, and therefore it is possible that the confidentiality of such communications may be breached by a third party.

● Email and text service providers may have access to your emails and texts. 

4.Your Medical Information

Your privacy is very important to us and you control the use of your personal information. SimpleMedVisits has put important safeguards in place to make sure your medical information is protected and safe to maintain its confidentiality. 

SimpleMedVisits seeks to work together with you to give you the best health care possible. Having access to your medical information will help your SimpleMedVisits doctor give you the best possible care because he/she will have the most up-to-date information about your health. Therefore, as allowed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and to help us give you the right care, in the right place and at the right time, your health plan and its contractors and agents (Health Plan) may electronically share with us your health-related information (including your “protected health information” as defined by HIPAA). Such shared health-related information may include things like visits to the doctor or hospital, medical conditions, current and past prescriptions, biometric data (height, weight, body fat percentage, etc.) and other health status-related information. 

5.Digital Communications Risks and Conditions

SimpleMedVisits offers members the ability to send and receive emails and texts to and from their care team. While SimpleMedVisitstakes many precautions to protect your information and the security of the emails and texts it sends, there are still risks. 

Risks: 

Transmitting patient information by email or text has a number of risks. These risks include but are not limited to the following: 

Covered Health Care Services). The SimpleMedVisits fee schedule for these services will be provided to you upon your request. SimpleMedVisits may amend the fee schedule from time to time in its sole and absolute discretion and without prior notice. ● If you request and receive a Non-Covered Health Care Service, Payment at Time of Service is Due in Full . We accept cash, credit or debit card payments. ● We do not submit claims to insurance companies, government programs, or any third-party payers. All Non-Covered Health Care Services provided by SimpleMedVisits are billed directly to the patient. ● You agree not to submit any claims to any third party payer or any government health care program for Covered Services rendered by SimpleMedVisits to you under this Agreement. ● All Fees paid are non-refundable. This includes all Fees that may have been paid whether such were paid on a monthly or annual basis. 

Conditions: SimpleMedVisits is not liable for improper disclosure of confidential information that is not caused by SimpleMedVisits misconduct. You must acknowledge and consent to the following conditions: 

● Email and text are not appropriate nor should they be used for urgent or emergency situations. Please call 911 in the event of a medical emergency. ● Per your request, SimpleMedVisits may send emails or texts to you as necessary for your diagnosis, treatment, billing, eligibility and other handling. You should not use email or text for sensitive communications (e.g., AIDS/HIV, mental health, developmental disability or substance abuse). 

You are responsible for informing SimpleMedVisits, in writing, if you want to cease or limit email or text communications with SimpleMedVisits. You may do so at any time without reason or explanation. ● You are responsible for protecting your email account or telephone password or other means of access to your email or text. SimpleMedVisits is not liable for breaches of confidentiality involving your email or telephone accounts that are caused by you or any third party.  

●Should limit or avoid use of public computers and public networks.●Should promptly inform SimpleMedVisits of changes in your email address or telephone number.●Before sending emails or texts containing personal health information to SimpleMedVisits, you should:oEnsure the email or text is addressed to the intended recipient.oList the key topic in the email subject line.oPut your name in the body of the email or text.oTake precautions to preserve the confidentiality of your emails or texts. Once SimpleMedVisits sends an email ortext from its network, it has no control over its confidentiality or security.

By signing this Membership Agreement, you acknowledge that you have received and read the above information. In addition, you agree to any instructions that SimpleMedVisits may impose regarding the sending and receipt of email or text communications containing patient information. 

Recommendations and Instructions: 

If you wish to send and receive emails or texts from SimpleMedVisits regarding your care and treatment, you:

Note: Patients can communicate securely with SimpleMedVisits if Patients via the SimpleMedVisits Patient Portal.

6.Term and RenewalThis Membership Agreement shall begin on the Effective Date and shall continue for one year until the first anniversary date, unless terminated within thirty (30) days of the Effective Date by submitting a Membership Cancellation Form. If terminated within thirty (30) days, you will only be charged the registration fee and the first month's Comprehensive Monthly Fee.This Agreement will automatically renew on the first anniversary date and each subsequent anniversary date unless you provide thirty (30) days written notice prior to the anniversary date. 

● You are responsible for informing SimpleMedVisits, in writing, if you want to cease or limit email or text communications with SimpleMedVisits. You may do so at any time without reason or explanation. ● You are responsible for protecting your email account or telephone password or other means of access to your email or text. SimpleMedVisits is not liable for breaches of confidentiality involving your email or telephone accounts that are caused by you or any third party. 

Cancellation Policy 

To terminate this Membership Agreement, you must complete, sign, and submit a Membership Cancellation Form to SimpleMedVisits. This form can be submitted via U.S. mail, overnight carrier, email [cancel@simplemedvisits.com], or fax. Membership Cancellation Forms can be obtained at www.SimpleMedVisits.com or by contacting SimpleMedVisits directly. 

The date of termination will be the last day of the month in which SimpleMedVisits receives the Membership Cancellation Form. Upon cancellation, once all payments for periods prior to the termination date have been received, you will not be responsible for any further payments. If the date on the form has passed (for instance, if request is retroactive), the form's submission date is the controlling date. 

Non-Refundable Fees All fees paid under this Membership Agreement, including but not limited to registration fees and monthly fees, are non-refundable, regardless of whether they are paid on a monthly or annual basis.

Termination by SimpleMedVisits SimpleMedVisits reserves the right to terminate this Membership Agreement at any time, subject to any professional obligations. Severability If any term, provision, covenant, or condition of this Membership Agreement is held by a court of competent jurisdiction to be invalid,  

void, or unenforceable, the remaining provisions will remain in full force and effect and will not be affected, impaired, or invalidated. 

Governing Law and Arbitration This Membership Agreement will be governed by and construed in accordance with the laws of the state in which the medical office SimpleMedVisits provider is located. By signing this Membership Agreement, you agree to have any dispute arising out of this Agreement resolved through neutral binding arbitration rather than by a jury or court trial. Any dispute will be submitted to arbitration in the country and state where you receive services covered by the Membership Agreement. The arbitration decision will be conclusive and binding on both you and SimplemedVisits. All arbitration provisions will be governed by, construed, and enforced in accordance with the Federal Arbitration Act. 7. Non-Transferability This Membership Agreement is non-transferable. If you have a complaint, please contact your SimpleMedVisits clinic directly or SimpleMedVisits in any of the following ways: 

Complaints Email: Complaints@SimpleMedVisits.com 

Phone: 254-425-4795 

void, or unenforceable, the remaining provisions will remain in full force and effect and will not be affected, impaired, or invalidated. 

Cancelations Email: Cancel@SimpleMedVisits.com

SimpleMedVisits Detailed Service List 

Covered Healthcare Services General Consultations Virtual visits with primary care physicians or general practitioners for common health issues (e.g., colds, flu, allergies, infections). Follow-Up Appointments Routine follow-up appointments for chronic conditions (e.g., diabetes, hypertension, asthma management). Prescription Refills Prescriptions for medications based on a virtual consultation, including refills for ongoing medications. Mental Health Referrals Referrals to counselor therapy sessions with psychologists, psychiatrists, or licensed therapists for conditions like anxiety, depression, stress, etc. Dermatology Consultations Remote evaluation and management of skin conditions (e.g., rashes, acne, eczema) via photo or video. Specialist Referrals Referral to specialists based on initial telemedicine consultations. Minor Acute Care Assessment and treatment of minor acute conditions, such as sinus infections, UTIs, conjunctivitis, and minor injuries. Wellness and Preventive Care Lifestyle counseling, dietary advice, smoking cessation support, and preventive health advice. Lab Test Orders and Reviews Ordering lab tests and reviewing lab results with patients remotely. Important Note: The cost of lab(s) tests is not covered by SimpleMedVisits and will need to be paid separately by the patient. Optional: Discounts are available for patients who pay directly to SimpleMedVisits for lab tests. In such cases, SimpleMedVisits will charge the patient 15% above the clinic cost. Chronic Disease Management Remote monitoring and management of chronic diseases like hypertension, diabetes, asthma, and high cholesterol. Consultations: Virtual visits for adult minor illnesses, follow-ups, and behavioral issues. or other auditory conditions.

Non-Covered Healthcare Services Emergency Care Immediate care for severe or life-threatening conditions (e.g., heart attacks, strokes, severe trauma) that require urgent, in-person intervention. In-Person Physical Examinations Comprehensive physical exams that require in-person interaction, such as annual physicals or specific examinations (e.g., abdominal palpation, detailed cardiac exams). Surgical Procedures Any type of surgical intervention or operation. Immunizations and Vaccinations Administering vaccines (e.g., flu shots, COVID-19 vaccines) which require in-person delivery. Advanced Imaging Services Imaging tests like X-rays, MRIs, CT scans, or ultrasounds that require specialized equipment and personnel. Dental Services Any dental care or procedures that require physical examination and treatment by a dentist. IV Therapy and Injections Administration of intravenous medications, fluids, or injections that require in-person administration. Hands-On Physical Therapy Physical therapy that involves hands-on manipulation or equipment not feasible through virtual means. Laboratory Procedures Blood draws, urine tests, or other lab tests that require in-person collection. 

Vision Tests and Eyewear Prescriptions Comprehensive eye exams that require specialized equipment and in-person assessments for eyewear prescriptions. Hearing Tests In-person audiometric testing that requires equipment to evaluate hearing loss or other auditory conditions.