Essential Legal Documents for Your Concierge Practice: The Complete Checklist

1. The Membership Agreement: Your Foundational Document

Everything else in your practice hangs off this contract. It defines what patients pay, what they receive, and—just as important—what they don't receive. A well-drafted membership agreement should nail down:

2. Medicare Private Contracts (If You've Opted Out)

If you opt out of Medicare—the route most full concierge models take—federal regulations require a written private contract with every Medicare beneficiary you treat. This is not a nice-to-have; it's a federal requirement with prescribed contents, and treating a Medicare beneficiary without a signed contract in place can jeopardize your opt-out status.

Key mechanics to build into your document workflow:

• The opt-out affidavit must be filed with your Medicare Administrative Contractor, and the opt-out runs in two-year cycles (affidavits filed since mid-2015 renew automatically unless you cancel)
• Private contracts must be signed before you furnish any service to that beneficiary
• The contract must contain specific acknowledgments—that you've opted out, that neither the patient nor you will bill Medicare for your services, and that the patient agrees to pay your charges
• You need a tracking system so no Medicare patient is ever seen without a current contract on file

The required contract contents are covered in more detail in our guide to Medicare compliance for concierge practices.

3. Patient Transition and Notice Letters

If you're converting an existing practice, your notice letters to current patients are legal documents, not marketing. Done wrong, they expose you to patient abandonment claims and board complaints. Your letter file should include:

• An initial written notice with the effective date, new terms, and the patient's options
• Follow-up notices (certified mail for some patients and some states)
• Referral assistance and records-transfer instructions for patients who don't join
• Documentation of every notice sent and every contact attempt

Thirty days is a common minimum, but many situations call for more, and requirements vary by state. See our full breakdown of the 30-day notice rule and transition requirements.

4. HIPAA Documents: Privacy Notices, Authorizations, and BAAs

Leaving insurance networks does not take you out of HIPAA's reach, and even practices that fall outside HIPAA's technical definitions face state privacy laws. Your privacy paperwork should include:

The BAA is the most commonly missed item on this list. Concierge practices adopt consumer-grade tools for messaging and scheduling; every one of those vendors needs to either sign a BAA or stay entirely outside the flow of patient information.

5. Informed Consent and Financial Policy Documents

Beyond the membership agreement itself, day-one paperwork should include:

• General consent to treat: Your baseline informed-consent documentation, plus procedure-specific consents where relevant
• Financial policy: A plain-language document explaining that membership fees are separate from insurance, what patients may still owe third parties, and how insurance and out-of-network care work alongside membership
• Insurance acknowledgment: For opted-out or out-of-network physicians, a signed acknowledgment that the patient understands what their insurance will and won't pay—this prevents the most common billing disputes months later

6. Employment Agreements and Restrictive Covenants

In a small practice, one departing employee can walk out with your patient relationships and your operational playbook. Staff documents to have in place before your first hire:

• Employment or contractor agreements defining duties, compensation, and termination terms—with correct worker classification, since misclassifying employees as contractors carries tax and labor-law consequences
• Confidentiality and non-solicitation provisions protecting patient lists, pricing, and business information
• Non-compete provisions, used carefully: Enforceability varies dramatically by state, several states limit or prohibit non-competes for healthcare workers specifically, and the law in this area continues to shift—this is a clause to draft with counsel, not copy from a template

7. Corporate Formation Documents and Entity Choice

Your entity is the legal wrapper around everything else: articles of incorporation or organization, bylaws or an operating agreement, and ownership records. Two reasons this deserves attorney attention rather than an online filing service:

Corporate practice of medicine (CPOM). States such as California and Texas prohibit general business corporations from practicing medicine or employing physicians to do so. In CPOM states, physicians typically must organize as a professional corporation or professional entity owned by licensed physicians, and arrangements with non-physician investors or management companies must be structured carefully. Forming the wrong entity type in a CPOM state can invalidate your structure from the start.

Liability and tax. Entity choice affects how membership revenue is taxed, how you pay yourself, and what stands between practice liabilities and your personal assets. The right answer depends on your state, your ownership plans, and whether partners will join later.

8. Telehealth Consent

If your membership includes virtual visits—and in most concierge models it does—add a telehealth-specific consent covering the limitations of remote evaluation, technology and privacy risks, and what to do in an emergency. Many states require documented telehealth consent, and state licensure rules generally turn on where the patient is located at the time of the visit, which matters when members travel or winter out of state. Build the consent into your onboarding flow rather than treating it as an afterthought.

The Master Checklist