Direct Primary Care Interest Survey
Health insurance has become expensive and unpredictable. We are exploring a new model that offers simple, affordable, and direct access to your care team—with no copays, no surprise bills, and priority access to a provider. This form helps us determine if there is enough interest to launch this service locally. Those who join this list may receive priority access to limited spots if we move forward.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Are you a current patient with HealthStar Physicians of Hot Springs? Our affiliates are Hamilton West Family Medicine, Lake Hamilton Family Medicine, West Gate Family Medicine, Lakeside Family Medicine, Fountain Lake Family Medicine, Glenwood Family Medicine, and FirstCare Walk-In Clinic.
*
Yes
No
Unsure
Do you currently have health insurance?
*
Yes – traditional plan and I pay a co-pay at doctor's visits
Yes – high deductible plan
No – I do not have insurance
Have you ever avoided going to the doctor because of cost?
*
Yes – frequently
Yes – occasionally
No
How many people would you want covered under this type of plan?
*
Just me
Me + spouse
Family (with children)
If your family had unlimited office visits, same/next-day appointments, and no copays for a flat monthly fee, how likely are you to join?
*
I would sign up immediately
Very interested
Maybe / need more details
Not interested
What monthly price per adult feels reasonable for this type of care?
*
Under $50
$50–75
$75–100
$100–150
$150+
What would matter MOST to you in this type of healthcare model?
*
Lower monthly cost
Same-day or next-day appointments
Longer visits with my provider
Being able to text/call my provider directly
No surprise bills / predictable pricing
How would you most likely use this type of service?
*
Replace my current insurance
Use it alongside insurance for better access
Use it only for basic care / sick visits
Not sure yet
What would make you switch to something like this?
If we launch this, would you like priority access to limited founding member spots?
*
Yes – notify me first
Maybe – I want more details
No
Submit
Should be Empty: