Direct Primary Care

What is Direct Primary Care (DPC)?

DPC is an affordable model of membership medicine that includes all primary care services with a single monthly fee. This allows unrushed 30-60 minute appointments, direct access to your provider, and a quality of care that improves your health. By not billing insurance, DPC removes a tremendous portion of the administrative costs making it affordable and in many cases less expensive than traditional medical practices. This puts the patient at the center of their care with their provider as a trusted partner.

What is included?

  • All preventive care visits, including gynecologic care
  • Care of chronic conditions, for example diabetes, hypertension, asthma
  • Urgent visits during office hours
  • Ability to contact your primary care provider directly when and how you need it through text, secure messaging, portal or phone
  • Procedures as indicated (specialty services may have additional charges click to inquire).
    • skin biopsy
    • sutures
    • EKG
    • abscess and cyst drainage
    • joint injection
    • basic wound care
    • ear wax removal
    • contraceptive device insertion and removal
    • endometrial biopsy
    • colposcopy
    • spirometry
  • Negotiated rates for labs. See PDF for prices.
  • Negotiated rates for studies. See PDF for prices (same as above).
  • In house pharmacy. See PDF for commonly used medications and our cash price (same as above).
  • Newsletter, YOGA, health talks with experts

Are there extra fees?

No! There are no visit fees or copays and most procedures are included in your direct primary care membership. If you receive any specialty procedures that do have a charge with us we will inform you of the total cost before you receive care. We believe in full transparency of health care costs.

Do I need insurance?

We recommend all patients have insurance. DPC is not insurance. It is important that you have insurance if you require hospitalization, surgery, or need to see a specialist. We do not require you to have insurance to be seen and insurance will not change your charges with us.

What if I have Medicare?

We have a commitment to offering care to Medicare patients, however Medicare requires that visits are billed. For Medicare we offer a reduced monthly fee of $100 and bill your Medicare and your secondary. Our model provides excellent coordination and quality for aging and disabled patients, personalizing the experience. Please contact us for more details.

Will I benefit from DPC if I don’t need frequent medical attention?

Of course. Everyone benefits from a service tailored directly to them. That’s why we offer truly custom healthcare. We are here for you if you are sick or hurt, but we also help you proactively maintain good health. Every visit with us will be thorough, relaxed, and as long as you need to address your health concerns. The longer you are our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.

How is DPC different from Concierge membership?

With concierge membership you pay an access fee to join the clinic and then you continue to use your insurance for covered services such as onsite or telemedicine visits, labs, and procedures. You may have co-pays and co-insurance. With DPC, there are no additional costs for telemedicine or onsite visits, and there are deep discounts for labs and procedures offered onsite. DPC monthly fees are less than the price of an office visit.

Prescription Refills

How do I get a prescription refill?

  • The easiest way to get your medication refilled is to text, email, or call the office. You can also ask your pharmacy to contact us on your behalf.
  • If you get your medications at our office – your provider may like to speak with you to find out how things are going prior to dispensing your next 3 month supply.
  • For narcotics or other controlled substances, we require you to check in with your provider per your contract. Our controlled substance contract describes our policies regarding these prescriptions.
  • If you need a prescription sent to a mail order pharmacy or phoned to a new pharmacy, call us to give the name of the medicine, strength, directions and quantity you are requesting, the pharmacy phone or fax number, and patient ID number if needed.

Calling the Office

What happens if I call the office with a medical question?

The quickest way to reach your provider is via Spruce text.  If you call the office the receptionist will give the message with your chart to the medical assistant, who will then call you back, usually within a few hours. You may be asked to schedule an appointment.

If you are asking for a prescription, please give us 48 hours notice. We will need a pharmacy number, any allergies, and what medicine you are calling about.

What if I want to speak directly to a Provider?

With Direct Primary Care and Concierge Medicine your provider is looking forward to speaking with you! The easiest way to get ahold of your provider is Spruce text. If it is urgent – please mark urgent and call if your message has not been responded to in 30 minutes. If it is a routine request please let us know that as well!


How do I make an appointment?

With DPC and Concierge Medicine, once you sign up we like to have the initial visit within a week. Follow ups and urgent visits can be made same day or next day.

For life-threatening emergencies, please call 911 first, then alert your provider of what is going on. She can call ahead to the Emergency Room to give the attending doctor some background information.

What if I need to cancel an appointment, or will be late?

Please let us know about cancellations promptly, ideally 24 hours ahead. There may be $35 no show/late cancellation fee if we are not informed ahead of time. If there are 3 or more no shows/late cancels within a year you may be asked to leave our practice.

Is there a co-payment?

DPC has no co-payment or other visit fees due. Concierge medicine may have fee for service fees due at the time of service including co-payments, and your share of the Medicare charges.

What should I always bring to an appointment?

A list of your concerns, any medication or supplements you take (pictures or actual bottles are much appreciated), allergies, adverse reactions.

Do I make an appointment if I need a form filled out by my Provider?

Please text or email your provider if you have forms to be filled out.  Spruce will allow you to upload the form as a PDF and the provider may contact you for more information if needed.


What do I need to know about referrals? How do I get one?

We are here to help you find the care you need. If your doctor needs consult with an outside physician, she will make a referral on your behalf. We will give the physician your phone number so that they can contact you directly to set up an appointment.

If you have a EPO or HMO (commercial or Medicare) and do not have out of network benefits you will need to contact your provider.

Retroactive referrals are generally not accepted by insurance companies.

If you plan to see another practitioner, but don’t need a referral:

Please let us know, we are here to help! While we don’t know all of the doctors in town, we do know quite a few and would like to help direct your care.

What if I want a second opinion?

We will be happy to help you arrange for a second opinion.

Lab Tests

Where will my lab tests be done?

DPC includes most of the tests we do in the office, including urinalysis, rapid strep, glucose, pregnancy, microscopic exams. For Medicare – we bill for these directly.

Our office has a contract with LabCorp to provide low cost labs directly to DPC patients. They will bill Medicare indepently. If you wish to use your insurance for labs, please let us know and we can pass along the information to LabCorp.

You may also request that we fax a prescription for lab work to another lab site if that is more convenient.

What is a “fasting” blood test?

If you are asked to “fast,” do not eat or drink anything for 8 hours before the test, except water, tea or coffee without sugar or milk.


What immunizations do you offer?

We participate in the Washington State Vaccine for Children (VFC) program. We offer the following vaccines for children at no cost, with a minimal to no charge.

  • DTaP (diphtheria, tetanus, acellular pertussis)
  • MMR (measles, mumps, rubella)
  • IPV (Polio)
  • Hepatitis B
  • Hepatitis A
  • Rotavirus
  • HIB (hemophilus)
  • PCV-13
  • Varicella (Chicken Pox)
  • Influenza
  • Gardisil (for HPV)
  • Mennigitis B – Trumeba

For adults we offer the flu cost at no cost to our DPC patients and there is a small fee for the Tetanus shot. Medicare will pay for flu shots.

  • Tdap (tetanus, diphtheria, acellular pertussis)
  • Influenza

We can write prescriptions for many other vaccines and you can go to a pharmacy.

Medical Records

Who has access to my medical records?

Your medical records are confidential. One of the nice things about DPC is that your insurance does NOT have the right to look at your medical records without your direct consent.  If you would like to release your medical records, for any reason, to anyone, please print and sign this release form (PDF).

Please see our Notice of Your Privacy Rights (PDF) for more information.

How will I be notified of test results?

You let us know! We would be happy to send you lab results via Spruce, email, phone, or letter. We also add your results to your patient portal

How do I request medical records?

Please sign a release of information.

Patient Satisfaction

What if I am unhappy with my care?

Please tell us! It is our intention that you get excellent care. But we can’t fix what we don’t know about. Call, come in or write us a letter so we can work with you toward a solution.

What if I am happy with my care?

Tell all your friends! Put it on the internet! We suggest adding a review on Google. You can friend or “like” us on Facebook. Help our practice to provide excellent care to more people!

Advanced Directives

What about Advanced Directives and Medical Power of Attorney (MPOA)? What is a POLST form, and do I need one?

Physician Orders for Life-Sustaining Treatment form (usually on bright green paper) is a list of medical orders, signed by your medical practitioner, stating what medical interventions you do, or do not, want for end of life care, if you are not able to speak for yourself.

Advanced Directives and Medical Power of Attorney statements are more general. If you have these, please bring in a copy and discuss it with your doctor. If you have named a Medical Power of Attorney, that person is supposed to authorize for you what you would have wanted if you were able to speak for yourself. Therefore, it is important that you tell that person directly what you would want.

Advanced directives, medical power of attorney and POLST forms only take effect when you are not able to speak for yourself. You are entitled to change your mind at any time, regardless of what you have written in the past.

In the absence of any instructions, in a crisis, or when in doubt, we will do everything we can to protect your life.