Membership Terms
New Jersey Family Enrollment, Care Consent & Membership Agreement
Six Things to Understand Before Enrolling
A fixed fee of $99.00/month for the whole household, regardless of the number of children. No fees for individual encounters, messages, or prescriptions within scope. Renews monthly; cancel anytime.
Remote pediatric guidance and triage for acute, day-to-day concerns between visits. It supplements—and does not replace—your child’s regular primary care pediatrician.
It is not an emergency service. Messages are not continuously monitored. In an emergency, dial 911 or go to the nearest emergency department immediately.
This membership is direct-pay healthcare, not health insurance. It does not cover outside labs, pharmacies, ER visits, or satisfy the NJ insurance coverage mandate.
Standard encounters use live two-way audio/video. Audio-only visits are strictly conditional based on the clinician’s medical judgment.
Designed to cover routine consents, privacy elections, and recurring payment terms so a new signature is not required for routine follow-on visits.
1. Practice Information & Contact
| Legal Entity | Sprout Care PC |
|---|---|
| Lead Physician | Dr. Benyamin Friedman (NJ License: 25MA12098400) |
| Practice Address | 9 Hemion Road, Suite 101, Suffern, NY 10901 |
| Direct Contact | Tel: (845) 773-1794 • Email: info@mysproutcare.com |
Sprout Care utilizes licensed pediatricians. The name, license type, and license number of the treating clinician will be furnished during each encounter and remain accessible for at least 72 hours.
2. Defined Terms
- Member: The parent or legal guardian enrolling the household.
- Enrolled Child: Any child registered and accepted into the Program.
- Program Services: Direct clinical guidance, triage, and encounters provided directly by Sprout Care clinicians.
- Membership Fee: The flat, recurring fee of $99.00 per month per household.
- Active Hours: Weekdays 7:00 a.m. – 11:00 p.m. ET; Weekends 9:00 a.m. – 10:00 p.m. ET.
- Encounter: A clinical interaction via real-time audio/video. A standalone text message exchange does not constitute an Encounter.
3. Scope of Services
Included in Scope
- Acute triage and evaluation between routine PCP visits
- Live two-way video/audio clinical encounters
- Store-and-forward review (photos, videos, consumer health readings)
- Common acute conditions (colds, coughs, rashes, fever, croup, mild tummy complaints, ear/eye symptoms, feeding questions)
- Non-controlled acute prescriptions when clinically appropriate
Excluded from Scope
- Well-child checks, growth charts, and routine immunizations
- Sports, camp, and school clearances
- Long-term chronic disease management or ADHD care
- Controlled dangerous substances (CDS) or psychiatric medication refills
- In-person procedures, direct labs, imaging, or home visits
- Emergency services or medical transport
4. Encounters & Operating Protocol
Video Encounters: The clinical standard for Sprout Care is two-way interactive video. Audio-only is utilized solely when the treating physician decides clinical safety standards are fulfilled.
Physical Location Requirement: Under New Jersey medical licensing rules, the parent/guardian must state the child’s physical location at the opening of each encounter.
Response Target: During Active Hours (7:00 AM – 11:00 PM weekdays; 9:00 AM – 10:00 PM weekends), the clinician response target is approximately one hour. This is an operational goal, not an emergency guarantee.
5. Telehealth Informed Consent & Home Diagnostics
By registering, the Member understands the benefits (rapid access, home comfort) and technical limits (lack of physical palpation or auscultation) of remote care. The clinician retains complete clinical discretion to redirect the patient to in-person urgent care or emergency facilities at any point.
Device & Photo Guidance: Any otoscopes, pulse oximeters, or thermometers must be operated gently by an adult according to manufacturer directions. Never force or restrain a child. Intimate/genital photographs are strictly prohibited.
6. Membership Billing, Renewal & Cancellation
| Subscription Rate | $99.00 / month flat rate for the entire registered household. |
|---|---|
| Billing Cycle | Automatic monthly recurring charge to the designated payment card. |
| Cancellation | Cancel anytime through the patient portal, email, or telephone. Sprout Care processes cancellations within 10 business days without cancellation penalties. |
| Rate Adjustments | Sprout Care guarantees a minimum 30 days’ written advance notice before any operational fee changes. |
7. Medical Records & Coordination of Care
Sprout Care coordinates with your child's primary care pediatrician. Encounter summaries are made available following clinical interactions. Medical records are maintained securely for at least 7 years in compliance with state regulations and HIPAA standards.
Legal Appendices & Disclosures
Appendix A: Notice of Privacy Practices (HIPAA)
Sprout Care PC adheres to the HIPAA Privacy and Security Rules (45 C.F.R. Parts 160/164) and New Jersey Telemedicine Privacy guidelines. Health information is protected and used strictly for clinical treatment, billing, and practice operations. Sprout Care does not sell health data, utilize personal information for targeted marketing, or share records with commercial data brokers. You may request copies of medical records, inspect documentation, or revoke communications permissions at any time.
Appendix B: Federal Good Faith Estimate (No Surprises Act)
Under the federal No Surprises Act, uninsured or direct-pay patients are entitled to an estimate of anticipated medical costs:
| Service Description | Billing Basis | Expected Fee |
|---|---|---|
| Sprout Care Pediatric Access Membership | Recurring Monthly | $99.00 / mo |
| Total Expected 12-Month Outlay | 12 Billing Periods | $1,188.00 / yr |
| In-Scope Clinical Encounters, Messages & Rx | Included | $0.00 |
| Third-Party Prescriptions, Lab Tests, ER Visits | Billed by third parties | Not billed by Sprout Care |