Thank you for taking time to fill this Membership Form out. This form includes required sections including our demographic section, accessibility form for determining sliding-scale tier; membership fee; and membership policies.
We have a unique model! Before we get started we wanted to offer a brief overview of how we work. Please review the sections below and sign acknowledging you understand and consent to our process.
STEP 1: Monthly Membership
You will sign up for a monthly membership using this form.
- You choose how much to pay per month ($15-$125/month per member). For reference, $68/month allows HLC to break even financially and keep our doors open! We utilize a sliding scale structure to make sure this feels accessible. For those who can pay more, this ensures our clinic remains open and also contribute to our Patient Care Fund which allows us to continue to offer sliding scale.
- Payments will auto withdraw from a debit or credit card monthly. Monthly memberships can be cancelled wit 10-days notice prior to the withdrawal date. Once you complete this form, our admin staff will help you get your Electronic Health Record (CHARM) set up which is where your membership payments will be securely drawn from.
STEP 2: Schedule an Appointment
Once you have filled out this form, please call (971) 231-4536 to finish setting up your membership account and schedule an appointment.
STEP 4: Meet with a Provider
We can't wait to meet you! As a reminder we offer primary care, naturopathic support, mental health, nutrition counseling, and Ayurvedic consults.
STEP 5: Pay for your appointment
Each appointment has a cost associated and is based on the type of appointment and length of time. You can pay with your insurance (we can check if you are covered in-network or out-of-network) or out of pocket (you can utilize our sliding-scale). We can also send you a superbill upon request.
Labs, imaging, and prescriptions can be billed through insurance if available.
Our admin staff can review all charges and payment options.
STEP 5: Join us for community events!
We try to host something monthly, from yoga to cooking classes. We will send event updates in our newsletter and post on social media. Add us!
Instagram
Facebook