Bene Beyond Direct Primary Care Sign Up

Are you ready to invest in your health? Are you looking for a doctor that will spend time getting to know you? Do you want a provider that speaks to you in a way you can easily understand? Are you tired of waiting longer for the doctor to arrive than the total time of your face-to-face visit?

At Bene Beyond Family Medicine, we value your time. The doctor waits for you. The doctor assesses your vital signs. We have extended appointments, and we don't double book. We value true relationship between the doctor and the patient.

We would love for you to join us. Enter your information below to get started.

1. First Name of Principle Enrollee*

2. Last Name*

3. Email*

example@example.com

4. Street Address

City

Currently this plan is only available in Texas. Do you live in Texas?

6. Zip Code

To select your direct primary care plan, please check all that apply. Verification required for some selections.*

Family Plan: $180/mo + $100 one-time enrollment fee (up to 2 adults and up to 3 children from same household)Individual Adult: $ 100/mo + $100 initial enrollment fee (for one adult age 18+)Individual College Student: $ 50/mo + $100 initial enrollment fee (for full time student age 18-26)Add 1 Additional Child: $ 20/mo (must also have Adult Individual or Family Plan)Add 2 Additional Children: $ 40/mo (must also have Adult Individual or Family Plan)Add 3 Additional Children: $ 50/mo (must also have Adult Individual or Family Plan)Add 1 Additional College Student: $50/mo (must also have Adult Individual or Family Plan)Add 2 Additional College Students: $ 95/mo (must also have Adult Individual or Family Plan)

Your one time deposit is: $

Your recurring monthly payment is: $

Your total first time payment is: $

Payment Amount

USDDirect Primary Care Initial Payment

Debit / Credit Card

Calculation

Signature