Patient Agreements

Sparks Family Medicine offers patient agreements for:

  • Patients with traditional insurance who want to access functional medicine.
  • Patients without insurance coverage or with insurance coverage that does not include Sparks Family Medicine as an in-network provider.
  • Patients who are members of a healthcare sharing ministry.

For information regarding patient agreements, please call Sparks Family Medicine at (702) 722-2200 or email ContactABA@sparksfamilymedicine.com

The patient agreement and enrollment form provides the patient agreement terms, benefits, payments, patient responsibilities and change/termination requirements. Patients who agree to execute a patient agreement and enrollment form during their first visit should know:

  • Patient agreement payments are processed up to three days prior to the patient’s initially scheduled appointment, are nonrefundable and require a credit card for recurring payments. (Payments may be applied to a rescheduled initial appointment if time permits.)
  • There are additional costs for accessing some services, including but not limited to specialty laboratory testing, supplements and prescriptions.
  • Patients are responsible for accessing services, providing payment for services when due, updating contact information and terminating the patient agreement prior to scheduled payments, (if necessary).

Patient agreements are available for review by prospective patients in the office during normal business hours. Patient agreements are not provided to prospective patients outside of the office. Prospective patients are not allowed to keep blank patient agreements. Patients will receive a copy of the executed patient agreement during their first office visit.