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Legal Templates
for Functional Medicine Practices

Whether you are starting from scratch, or you realized you have a few legal gaps to fill – Functional Lawyer™ has you covered. Be sure to read our 4 W’s under the Learn More tab about each document so you’ll know exactly what you need (and why)! 

Each of our documents is written and edited by expert functional medicine lawyers who understand the unique needs of a functional medicine practice. 

Are you overwhelmed and don’t know what you need or where to start? Download our free Essentials Guide here

Do you already know what is missing from your practice? Browse our extensive collection below.

Office Essentials
Website
Employment
HIPAA

Office Essentials

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Program Practice
Bundle

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Buy together and save! The quick-start set of the most essential documents needed for a package-or program-based practice:

  • Patient Program Agreement (Three Months/Six Months);
  • Informed Consent;
  • Notice of Privacy Practices;
  • Medicare Opt-out Affidavit & Instructions; and
  • Private Contract.

 

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Fee-For-Service Practice Bundle

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Buy together and save! The quick-start set of the most essential documents needed for a fee for service-based practice:

  • Fee For Service Agreement;
  • Informed Consent;
  • Notice of Privacy Practices;
  • Medicare Opt-out Affidavit & Instructions; and
  • Private Contract.

 

 

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Membership Practice
Bundle

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Buy together and save! Includes the most essential documents needed to start your cash-based functional medicine membership practice:

  • Patient Membership
  • Agreement;
  • Informed Consent;
  • Notice of Privacy Practices;
  • Medicare Opt-out Affidavit & Instructions; and
  • Private Contract.

 

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Discontinuation
of Care Letter

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A document ensuring you meet your legal and ethical obligations to your patients, terminating your physician-patient relationship and ensuring the patient knows how to seek continued care elsewhere.

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Patient Authorization and Consent for Release of Testimonial

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A written record of a patient giving your office permission to use their words (and sometimes recordings, image, likeness, name, age) in a variety of settings.


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Medicare Opt-Out Affidavit and Instructions

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A sworn statement signed by a provider applying to opt-out of Medicare. It has technical requirements and must be submitted with a request to opt-out.

 

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Private Medicare
Contract

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A patient contract between Medicare beneficiaries and providers who opt out of Medicare, explaining the nature of the opt-out status and the rights of the patient.

 

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Notice of Privacy Practices Bundle

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Under HIPAA, covered entities are required to provide patients with a copy of the Notice of Privacy Practices, and the Acknowledgement provides the written proof of compliance with HIPAA.

 

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Informed Consent

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A written record of a conversation between a provider and patient that includes a discussion of the risks, benefits, and alternatives of the care provided by the provider or their practice.

 

 

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Program/Package Agreement (3 months, 6 months)

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An essential contract for your program/package patients which sets forth the division of liability by clearly outlining the rights and obligations of both the patient and practice.



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Fee-for-Service
Agreement

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An essential contract for fee-for-service practices that sets forth the agreement between the practice and the patient; sets forth the division of liability; and sets forth how and when payment is to be made.

 

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Patient Membership Agreement

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A patient agreement for membership practices. It describes the scope of your services and sets out what is and what is not included in the membership (which you can customize for your needs).

 

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Office Policies and
Procedures

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What is it? A document outlining the policies and procedures of the office surrounding an initial consultation, including: Initial Consult Time limitations, Appointment Cancellation Policy, Refund Policy, and more.

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Letter to Insurance
Carrier

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Use this letter as a template for you to notify any insurance carriers that you intend to work out-of-network in your functional medicine or other cash-based practice.


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Group Visit Consent and HIPAA Authorization

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Use this template to ensure your group visits comply with the HIPAA Privacy Rule and to ensure you are notifying patients of their legal rights. If your group visits are virtual, use in tandem with Telemedicine Consent.

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Health Coaching Client Agreement

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A client agreement for health coaches to use with their 1-on-1 clients that outlines the terms of the relationship. 

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Website Essentials

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Website Essentials Bundle

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Buy together and save! This bundle includes the most essential documents you need for your website:

  • Terms and Conditions;
  • Privacy Policy; and
  • Disclaimer


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Website Terms & Conditions

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An agreement between you and your website visitors.It sets forth the division of liability by setting out the scope of what the website is and is not. It also sets the rules for their use of the site, tells them that the website is yours, and tells them what they can expect as a visitor. 

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Website Privacy Policy

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A published policy that sets forth how your website treats and protects visitors’ personal information and contact information.





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Website Disclaimer

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A statement explaining what your website is, what it is not, and how people should expect to interact with your website; which clearly sets forth the limitations of the information on your website and how the information can be used or interpreted.

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Telemedicine Consent

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Legally required by a majority of states: A patient’s written consent for the use of telemedicine visits, including acknowledging the risks, benefits, and alternatives of the remote care provided by the provider or their practice.


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Online Course Agreement

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Terms and Conditions for your online course that set the rules for payment, refunds, expectations, and significantly reduce your liability.




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Online Membership Agreement

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Terms and Conditions for your online membership program that set the rules for payment, refunds, expectations, and reduce your liability.

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Employment Essentials

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Employment Contract Agreement- MD/DO

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An employment contract between your practice and an MD/DO for when you are ready to hire and expand your practice.

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Employee Contract –
Office Staff

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An employee contract between your office and a staff member.



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Employment Contract – Health Coach/Nutritionist

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An employment contract between your office and a health coach-level or nutritionist-level provider.

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Independent Contractor Agreement – Health Coach/Nutritionist

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An independent contractor agreement between your practice and a health coach, nutritionist, dietician, or other complementary providers.

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Independent Contractor Agreement – MD/DO/ND/DC/NP/PA

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An independent contractor agreement between your practice and an MD, DO, DC, ND, NP, PA, and other similarly situated providers.

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HIPAA Compliance

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Business Associate Agreement

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Required for business associates under HIPAA. An agreement that your business associates will appropriately safeguard the PHI it receives or creates on behalf of your office.

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HIPAA Bundle

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Buy together and save! All of the HIPAA documents on Functional Lawyer™ in a convenient package at a savings of over $200 when bought together.


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 Get the FREE guide:

The 5 Essential Documents That Every Functional Medicine Doctor Must Have

Functional Lawyer is not a law firm nor a substitute for an attorney or law firm.  The information and templates available on Functional Lawyer’s website are for informational purposes only and not for the purpose of providing legal advice.  Though Functional Lawyer aims to keep its information and templates up-to-date and accurate, because the law changes rapidly and because of variations in laws in different jurisdictions, Functional Lawyer makes no guarantees as to the accuracy and completeness of the information.  It is your responsibility to ensure that the information and templates you choose to utilize from Functional Lawyer are appropriately tailored to and accurate for your particular business.  Communications between you and Functional Lawyer are not protected by the attorney-client privilege or as work product.  You should contact an attorney in your state to obtain advice with respect to any particular legal issues or problems and/or state specific requirements or customizations necessary for your business.  Use of Functional Lawyer’s website and its products are subject to our Terms & ConditionsEnd User License AgreementPrivacy Policy, and Full Disclaimer.