You’re just a few steps away from joining KC Primary Care.
The enrollment process
Each form opens pre-filled where possible. Take your time — there’s no clock. If you need to stop, just pick up where you left off.
Your name, date of birth, contact info, and insurance details. If you’re uninsured that’s perfectly fine — just leave that section blank.
A brief health history including medications and past conditions. If you have records at another provider, you can authorize a transfer here — or skip that part.
Review and sign the Concierge Care Member Agreement. This outlines the terms of your direct-care membership with KC Primary Care.
Choose your membership tier and set up recurring billing. Monthly and annual payment options are available.
First, you’ll sign the required HIPAA Notice of Privacy Practices — this is mandatory for all patients. The second form is an optional waiver if you’d like to authorize KC Primary Care to share your health information with a specific third party (family member, employer, etc.).
Before you start
Gather these items now for the smoothest experience. Everything marked optional can be skipped — you can always provide it later.
The whole process takes about 20 minutes.
Your care team is waiting on the other side.