Select Your Membership Tier

The below form is for current patients or prior patients looking to re-enroll. To ensure uninterrupted care, please submit this form by April 1, 2025. Review our list of FAQs Here.

***Excluding patients enrolled as an EMPLOYEE of Clark County Ohio or Aligned Marketplace***

Name:

First Name

Last Name

Email:

Phone:

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Select Your Prefered Tier:

Tier 1: $199/month (or $2,000/year) – Comprehensive Functional Medicine & Primary Care, unlimited appointments, exclusive discounts, and full patient portal access.

Tier 2: $85/month – Limited Functional Primary Care with 5 annual scheduled appointments per year & standard access to Spruce. No discounts or additional resources. Unlimited acute care visits.

Tier 3: $75/month – Hormones/Functional Medicine Only – One appointment per 90 days, focused on gut health or hormone support. No acute care visits included.

Tier 4: $55/month – Primary Care Only – Two appointments per year, unlimited acute care visits. No functional medicine support.

Tier 5: $20/month – Minimal Care Plan – One 90-minute appointment per year + medication prescription refills. Additional visits: $40 per appointment.

Add On Child 1:

Children (ages 0-17) are $10/month per child if a parent is enrolled in Tier 1 or 2. If no parent is in these tiers, the child is automatically placed in Tier 5 at $20/month. Membership includes one annual visit and unlimited acute care.

First Name

Last Name

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Add On Child 2:

First Name

Last Name

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Add On Child 3:

First Name

Last Name

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Add On Child 4:

First Name

Last Name

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Add On Child 5:

First Name

Last Name

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Add On Child 6:

First Name

Last Name

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