VIRTUAL DIRECT PRIMARY CARE (DPC) ADULT MEMBERSHIP GUIDE, SCOPE OF CARE & PATIENT CONSENT

VIRTUAL DIRECT PRIMARY CARE (DPC)

Membership Guide, Scope of Care & Patient Consent

Optimize by JaeNix | JaeNix, PLLC
Virtual Services | Adults Only (18+)
Medical Director: Sunil Kurup, MD

1. What Is Virtual Direct Primary Care (DPC)

Virtual Direct Primary Care (DPC) is a cash-pay medical membership that provides adult patients access to medical care through secure phone and video visits.

This program focuses on:

• Preventive care

• Stable chronic condition management

• Metabolic and wellness-based care

This membership is not insurance and does not replace emergency or hospital care.

2. Membership Pricing & Billing

Monthly Membership Fees

• Ages 18–59: $99/month

• Ages 60+: $139/month

Optional Annual Prepay

• 15% discount when paid in full for 12 months

• Cash or Zelle only

• Annual prepay is non-refundable

Billing Rules

• A valid debit or credit card must remain on file at all times

• Membership fees are billed automatically each month

• A $25 late fee applies after 3 days past due

• Accounts past due 7 days may be suspended or terminated

• Re-enrollment after termination is not guaranteed

3. Visit Structure, Requests & Response Times

Your membership includes up to two (2) virtual urgent care visits per month.

How Visits Are Requested

• All visit requests must be submitted through your secure patient portal

• Appointments are not scheduled through a public calendar

Provider Response Times

• As soon as possible

• Within 24 hours during normal business hours

• Messages sent after business hours are addressed the next business day

Visit Types

• Secure video visits

• Secure phone visits

This service is not real-time messaging and is not monitored 24/7.
Because response times may be up to 24 hours, this program is not appropriate for urgent or emergency situations.

4. Communication Platform

All communication occurs through a secure, HIPAA-compliant medical system.

You may:

• Send and receive private medical messages

• Participate in secure phone or video visits

• Complete forms and consents online

• Receive records, lab orders, or referrals via secure medical fax when needed

5. Time Zone

All scheduling, messaging, and visit times follow Central Time (Dallas, Texas), regardless of patient location.

6. Services Included

• Acute illness care (e.g., colds, sinus infections, UTIs, rashes)

• Stable chronic disease management (blood pressure, thyroid, cholesterol)

• Prediabetes and Type 2 diabetes not on insulin

• GLP-1 weight management coordination (medications billed separately)

• Female hormone optimization (non-testosterone)

• Fatigue, sleep, stress, and metabolic optimization

• Lab ordering, imaging, and specialist referrals

• Secure provider communication

7. Services Not Provided

This membership does not include:

• Pediatric care

• Emergency or hospital-level care

• Insulin initiation, titration, or pump management

• Testosterone prescribed via virtual visits

• Any controlled substances, including:

  • ADHD stimulants

  • Benzodiazepines

  • Opioids

  • Phentermine

  • Controlled sleep medications

• Suboxone, buprenorphine, methadone

• MAT/MOUD or addiction medicine services

• Detox or withdrawal management

• New psychiatric medication initiation

8. Mental Health Medication Policy

Anxiety or depression medications may only be continued if:

• You are already stable on the medication

• Medical records or pharmacy verification are provided

• The medication is not controlled

New psychiatric medication starts and crisis-level psychiatric care are not provided.

9. GLP-1 & BHRT/HRT Add-On Programs

GLP-1 weight management and BHRT/HRT programs are optional add-ons and require:

• Separate enrollment

• Separate laboratory testing

• Separate medication fees

These programs are not included in the DPC membership fee.

10. Commercial vs Compounded Medications

Medications may be sent to:

• Commercial pharmacies, or

• Select Texas-based compounding pharmacies

All medication costs, shipping fees, and lab requirements are discussed and agreed upon prior to ordering.

Compounded medications require a separate informed consent.

11. Manufacturer Cash-Pay GLP-1 Programs

Manufacturer programs (e.g., Lilly Direct, Novo Nordisk) require:

• Strict 30-day continuous refills

• No micro-dosing

• No skipped or delayed refills

Violation of manufacturer rules results in loss of the discount and compounded medication or full price with manufacturer becoming the only option.

12. Testosterone & Texas Law

Testosterone is not prescribed through virtual visits.

Testosterone requires:

• In-person Texas visit

• Physical exam

• Baseline and ongoing labs

• Compliance with Texas controlled-substance laws

13. Mandatory Lab Monitoring

GLP-1 Programs

• Baseline labs

• Repeat labs every 90 days if progress is inadequate

• No refills without completed and reviewed labs

HRT/BHRT Programs

• Baseline hormone labs

• Labs every 90 days

• No refills without completed and reviewed labs

14. Labs, Insurance & Financial Responsibility

Insurance may be billed for labs; coverage is not guaranteed.

You are financially responsible for:

• Any lab charges not covered by insurance

• Any balance billing from the lab

Cash-pay lab pricing requires full payment to the clinic prior to ordering.
If you do not pay the clinic directly, the clinic is not responsible for lab pricing or balance billing.

15. Insurance, HSA/FSA & Superbills

This is a cash-pay practice. The clinic does not:

• Bill insurance

• Verify benefits

• Submit claims

• Communicate with insurance on your behalf

A superbill may be provided upon request.
Reimbursement is not guaranteed, and you remain financially responsible regardless of outcome.

16. Administrative & Paperwork Fees

Completion of administrative paperwork (disability forms, employer forms, legal documentation) is at provider discretion and may require medical director review.
Additional administrative fees may apply.

17. Medical Director Oversight

Optimize by JaeNix operates under the supervision of Sunil Kurup, MD. Charts are reviewed, and physician consultation is available when clinically indicated.

18. Membership Term & Cancellation

• A 90-day minimum commitment is required

• After 90 days, membership converts to month-to-month

• Cancellation requires 7 days’ written notice via email to:
  [email protected]

• Late cancellations apply to the next billing cycle

• No partial, retroactive, or prorated refunds are provided

19. Medicare & Medicaid Exclusion

This clinic does not participate with Medicare or Medicaid.

By enrolling, you certify that:

• You are not enrolled in Medicare or Medicaid

• You will notify the clinic immediately if this changes

Discovery of Medicare or Medicaid enrollment results in immediate termination without refund.

20. Emergency Disclaimer

This program does not provide emergency care.

Call 911 or go to the nearest emergency department for:

• Chest pain

• Stroke symptoms

• Severe breathing difficulty

• Uncontrolled bleeding

• Severe allergic reactions

• Suicidal thoughts

Final Patient Consent & Acknowledgment

By signing below, I confirm that I am at least 18 years old and voluntarily enrolling in a cash-pay Virtual Direct Primary Care membership with Optimize by JaeNix, JaeNix, PLLC. I acknowledge that this program is not insurance and does not provide emergency care.

I understand the scope of services, exclusions, billing rules, laboratory and medication responsibilities, mandatory monitoring requirements, cancellation terms, and financial obligations outlined above. I acknowledge that all services are provided at provider discretion and may be declined if medically inappropriate or outside the scope of Virtual DPC.

By signing, I confirm that I have read, understand, and agree to all terms, policies, limitations, and conditions associated with this membership.