Welcome to Be Well Family Care!

NEW PATIENT REGISTRATION

Please watch the entire video before submitting the form below. We will contact you once we have the availability to schedule with your desired provider. You will receive an email confirming receipt of your form. Please note that it could take several weeks or months for us to call you to schedule depending upon the provider you choose and their availability.  

New Patient Registration Form


Stay Well Payment Plan:

  • $150 per month if you have Commercial Insurance 
  • $170 per month if you do not have Commercial Insurance
  • $110 per month if you have Medicare 

Discounts available for spouses, children, and an annual payment option


Functional Fee Payment Plan (non Stay Well)

There are 2 charges associated with most office visits. The first is the $100 Functional Fee which is not submittable to insurance and must be paid at the time of visit. The second is the office visit charge which we do submit to insurance. Anything that your insurance does not pay you will be responsible for. So if you pay out of pocket for your co-pay or deductible you can expect to pay out of pocket for that charge. We do not charge the Functional Fee for a true "acute sick visit" or for a yearly physical - these visits are submitted to insurance only.