Services Policy

Effective Date: 3/28/26

Last Updated: 8/10/26

1. Overview

This Services Policy describes the terms and conditions under which revolution health alliance PLLC, doing business as Midlife Metabolic Medicine (“MMM,” “we,” “our,” or “us”) provides clinical services to patients. By scheduling an appointment, enrolling in a program, or otherwise engaging our clinical services, you agree to the terms described in this policy.

Midlife Metabolic Medicine is a telehealth nurse practitioner practice providing metabolic weight management and hormonal medicine services. All clinical services are delivered via telehealth pursuant to Idaho’s Virtual Care Access Act (I.C. § 54-5703 et seq.) and applicable Oregon telehealth statutes. Clinical services are provided to patients located in Oregon and Idaho by Denise Erland, FNP-C.

2. Scope of Services

MMM provides clinical care focused on metabolic weight management, hormonal medicine, and related conditions including insulin resistance, prediabetes, type 2 diabetes, high cholesterol, high blood pressure, hypothyroidism, and perimenopausal hormonal dysfunction. Our services include clinical evaluation, individualized treatment planning, medication management (including GLP-1 receptor agonists, metformin, bioidentical hormone replacement therapy, and thyroid medications), clinical nutrition prescriptions, exercise prescriptions, remote patient monitoring, and ongoing metabolic and hormonal stewardship.

MMM does not provide emergency medical services, primary care for conditions unrelated to metabolic and hormonal health, mental health counseling or psychotherapy, surgical services, or care for patients outside of Oregon and Idaho. If you are experiencing a medical emergency, call 911 or go to your nearest emergency department.

3. Licensure and Geographic Requirements

Clinical services are provided to patients located in Oregon and Idaho. You must be physically located in one of these states at the time of each telehealth visit. If you relocate permanently to a state in which we do not provide clinical services, we will assist with a transition plan and provide clinical records to your new provider, but we will not be able to continue providing clinical care.

If you travel or split time between states, you must be physically located in Oregon or Idaho at the time of each scheduled visit. If an extended absence from both states is anticipated, discuss scheduling accommodations with your provider in advance.

4. Services and Pricing

4.1 Discovery Visit

A no-charge 15-minute introductory telehealth conversation to answer your questions, determine clinical fit, and outline next steps. The Discovery Visit is not a clinical evaluation and does not establish a provider-patient relationship for treatment purposes. No fee is charged.

4.2 Metabolic Evaluation (Month One)

Care at MMM begins with a six-month clinical partnership. Month one is the Metabolic Evaluation: a comprehensive diagnostic evaluation consisting of a 60-minute intake appointment, a comprehensive laboratory assessment ordered at a level of complexity matched to your individual metabolic and hormonal picture (including hormonal labs), a baseline monitoring window using your clinical monitoring kit, and a 60-minute Review of Findings with specific clinical recommendations. The month-one fee is $995, billed at booking. The evaluation takes approximately four weeks. The evaluation’s two visits — the intake appointment and the Review of Findings — are to be completed within 60 days of purchase. Your clinical monitoring kit ships at booking (see Section 8). Laboratory work is ordered through Quest or Labcorp and billed to your insurance with diagnosis-supported coding wherever possible; any testing your plan does not cover is offered at disclosed cash-pay pricing before the draw (see Section 5.3). Month one is fully self-contained: the findings and the monitoring kit are yours to keep regardless of whether you continue, and nothing continues automatically past month one.

4.3 Metabolic Rebuild (Months Two Through Six)

If you elect to continue past the Metabolic Evaluation, months two through six comprise the Metabolic Rebuild, completing the six-month clinical partnership. The fee is $995 per month ($5,970 total across the six-month partnership); payment in full is available on request. Continuation is opt-in: nothing continues automatically past month one. On electing to continue, month two opens a 60-day opt-out window during which you may step out at any point, no questions asked; past the window, you are committed for the remainder of the six-month term (see Section 6.2).

The Rebuild includes: two 45-minute treatment plan onboarding sessions at the start of month two; thereafter a minimum of 60 minutes of 1:1 visit time per month, scheduled as biweekly 30-minute or monthly 60-minute visits by shared decision; HIPAA-compliant messaging with 48-business-hour response; weekly provider review of monitoring-device trends (body composition, overnight HRV, sleep, and blood pressure) between visits; member office hours access by appointment twice per week; the weekly Metabolic Lab group telehealth session (see Section 4.7); medication management including GLP-1 receptor agonists, hormone replacement therapy, and other metabolic medications when clinically indicated (medication costs are separate from all program fees); an individualized clinical nutrition prescription with adjustments at every visit and curated recipe library access; an individualized exercise prescription with HRV-informed intensity guidance; an individualized, phase-periodized strength program built by your provider and progressed monthly; repeat laboratory reassessment at 16 weeks (insurance-routed wherever possible; disclosed cash-pay pricing otherwise); individualized supplement recommendations if indicated with a 15% supplement discount; and a 15% discount on any laboratory testing you pay out-of-pocket for because your insurance does not cover it.

4.4 Active Care

Ongoing structured care for patients whose metabolic and hormonal picture is still actively evolving after the six-month partnership. The fee is $395 per month, billed monthly. Active Care includes six 45-minute clinical visits per year (bimonthly cadence); continued messaging access with 48-business-hour response; member office hours access by appointment weekly; continued weekly Metabolic Lab access; ongoing medication management including hormone replacement therapy (medication costs separate); quarterly lab reassessments as indicated (insurance-routed wherever possible; disclosed cash-pay pricing otherwise); quarterly nutrition, exercise, and strength program review and adjustment; curated recipe library access; 15% supplement discount; 15% discount on out-of-pocket laboratory costs; and a 20% discount on enrollment in any new programs or courses MMM develops. Active Care is month-to-month with 30 days’ written notice required to discontinue.

4.5 Steady Care

Long-term metabolic and hormonal stewardship for stabilized patients. The fee is $250 per month, billed monthly. Steady Care includes four 45-minute clinical visits per year (quarterly cadence); continued messaging access with 48-business-hour response; member office hours access by appointment weekly; continued weekly Metabolic Lab access; medication management at each visit including ongoing hormone replacement therapy management (medication costs separate); an annual comprehensive lab reassessment anchoring one of the four quarterly visits (insurance-routed wherever possible; disclosed cash-pay pricing otherwise); an annual supplement review if indicated; an annual strength program reassessment; curated recipe library access; 15% supplement discount; 15% discount on out-of-pocket laboratory costs; and a 20% discount on enrollment in any new programs or courses MMM develops. Steady Care is month-to-month with 30 days’ written notice required to discontinue.

4.6 Panel Capacity

Your provider personally manages a maximum of 60 concurrent 1:1 patients across the Metabolic Rebuild, Active Care, and Steady Care. This is a fact of practice design that preserves the depth and quality of the clinical relationship. Discovery Visits and standalone Metabolic Evaluations do not count toward the panel. When the panel is full, Metabolic Evaluations may still be completed, but continuation into the Rebuild moves to a dated waitlist (see Section 8.4 regarding monitoring data during a waitlist period).

4.7 The Metabolic Lab

The Metabolic Lab is a weekly 45-minute group telehealth session included in the Metabolic Rebuild, Active Care, and Steady Care, consisting of clinical teaching, open data Q&A, strength-form review, and peer community. Sessions are live-only and are not recorded. No individual medical advice is given in the group setting; individual questions are addressed in your 1:1 visits or through portal messaging. Group-visit consent is obtained at enrollment. Metabolic Lab attendance is optional and does not count against your visit frequency at any tier.

4.8 Scheduling, Cancellations, and Missed Visits

Recurring visits are scheduled as standing appointments: you select a day and time that remains reserved for you throughout your care at a given cadence. Because your membership guarantees ongoing provider time and continuity rather than a fixed set of individual appointments, a missed visit is addressed by rescheduling where possible rather than by refund or credit. To change or cancel a standing visit, please provide at least 24 hours’ notice. A visit changed or cancelled with less than 24 hours’ notice cannot be reoffered that week and is treated as delivered, except as provided below.

During the Metabolic Rebuild, your monthly deliverable is a minimum of 60 minutes of 1:1 provider time delivered on your elected cadence. If you cancel a Rebuild visit with at least 24 hours’ notice, we will make that time whole within the same calendar month where scheduling permits — through an alternate appointment time that week — so that your 60-minute monthly minimum is restored, whatever your elected cadence. Rebuild time is measured within the calendar month and is not carried forward; if the full 60 minutes cannot be delivered within the month, the shortfall is forfeited.

During Active Care and Steady Care, where visits occur at a bimonthly or quarterly cadence, a visit cancelled with at least 24 hours’ notice will be offered a make-up appointment, and such make-ups receive scheduling priority.

A visit cancelled with less than 24 hours’ notice, or a missed appointment (no-show), is forfeited. As a courtesy, one late cancellation or missed visit is forgiven and treated as an ordinary reschedule — once per six-month clinical partnership for Metabolic Rebuild patients, and once per rolling twelve months for Active Care and Steady Care patients.

If you arrive late to a scheduled visit, you will be seen for the remainder of the reserved time; visits end at their scheduled end time to protect the appointment reserved for the following patient. Arrival more than ten minutes late without notice is treated as a missed visit.

If MMM reschedules or cancels a visit — due to provider illness, emergency, or other unavailability — there is no penalty to you and you are not charged for the affected visit. Where a rescheduled visit cannot be accommodated within the applicable period, your six-month partnership end date is extended accordingly, consistent with Section 7.

Repeated late cancellations or missed visits — three or more within any rolling six-month period — will prompt a conversation about scheduling and fit. Where a pattern persists, your standing appointment time may be released, consistent with the panel-capacity design described in Section 4.6, so that it can be offered to another patient. This does not terminate your care, and rescheduling into available times remains possible.

Format-specific scheduling terms. Discovery Visits are scheduled at least one day in advance and may be cancelled or rescheduled up to 12 hours before the appointment; a Discovery Visit not joined within 5 minutes of its start time is treated as missed and may be rebooked at any time. Member Office Hours slots may be cancelled or rescheduled up to 1 hour before the slot; a slot not joined within 5 minutes of its start is forfeited. Neither service carries a fee.

4.9 Appointment Times and Time Zones

All appointments are scheduled and administered in Mountain Time, the practice’s operating time zone. Within your patient portal, appointments are displayed in your own local time zone, and appointment confirmations state both your local time and Mountain Time to avoid confusion. Patients located in Pacific Time observe a consistent one-hour difference from the practice’s Mountain Time schedule.

Because the states in which we provide care observe Daylight Saving Time on the same schedule, your local appointment time does not shift when clocks change, and no action is required on your part at Daylight Saving Time transitions.

4.10 Intake Forms and Consents

Your intake paperwork and consent forms are sent to you through Practice Better when you purchase your Metabolic Evaluation, so that you have the full kit-transit and device-setup period in which to complete them.

All intake paperwork and consent forms must be completed at least 72 hours before your scheduled intake appointment. Your intake cannot proceed without them. Please schedule your intake with enough lead time to complete your forms, and contact us if you need assistance with any of them.

5. Payment Terms

All payments are processed through Stripe. We accept major credit cards, debit cards, and ACH transfers where supported by Stripe. Payment is due at the time of service or at the beginning of each billing cycle for monthly memberships and payment plans.

5.1 Insurance

Midlife Metabolic Medicine is not an insurance-based practice for clinical visits and memberships. We do not bill insurance for our program or membership fees. Operating outside of insurance allows us to determine visit length, visit frequency, diagnostic scope, and intervention selection based solely on your clinical needs. Laboratory work is handled differently: we order your labs through your insurance whenever possible (see Section 5.3). We provide superbills for all program and membership fees on request, which you may submit to your insurance company for possible out-of-network reimbursement. Reimbursement rates and eligibility vary by plan; coverage is not promised. Providing the superbill is the extent of our participation in the reimbursement process; we are not able to engage in disputes or advocacy with insurance carriers on your behalf.

5.2 HSA and FSA

All services at Midlife Metabolic Medicine are eligible for payment through Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).

5.3 Laboratory Costs

By default, laboratory work is ordered through Quest or Labcorp with diagnosis-supported coding so the laboratory bills your insurance directly. If your plan denies a panel or add-on as not medically necessary, that testing is offered at disclosed cash-pay pricing before the draw — pricing varies by patient and is always disclosed in advance. Testing not covered by insurance may be ordered through Rupa Health. You receive a 15% discount on any laboratory testing you pay out-of-pocket for because your insurance does not cover it.

5.4 Late and Failed Payments

If a scheduled payment fails, we will attempt to process the payment again and notify you via your patient portal. If payment is not resolved within 14 days, clinical services may be paused until the balance is current. Persistent non-payment may result in discontinuation of services. We will provide 30 days’ notice before any service interruption and will not withhold access to your medical records due to an outstanding balance.

6. Refund Policy

6.1 Month One (Metabolic Evaluation)

The month-one fee ($995) is billed at booking. If you cancel before your monitoring kit ships, you receive a full refund. If you cancel after the kit has shipped but before your intake appointment, you receive a full refund less the cost of the monitoring kit ($675); the kit is yours to keep. Once the intake appointment has been completed, the month-one fee is non-refundable (the clinical services have been rendered). The findings and kit are yours to keep in every scenario.

6.2 Continuation and the Opt-Out Window

Nothing continues automatically past month one; continuation into the Metabolic Rebuild is your affirmative election. On election, month two opens a 60-day opt-out window: you may step out at any point during the window, no questions asked. Completed months are billed and not refunded; the opt-out halts all remaining months. If the opt-out is exercised partway through a billed month, visits already scheduled within that month are delivered; all visits and billing after that month are cancelled. If you paid in full, any amounts paid for months not yet begun are refunded. Past the opt-out window, you are committed for the remainder of the six-month term and the remaining months are billed per your payment schedule. You keep all monitoring devices in every scenario. The return path after any exit is re-entry through Active Care, subject to current panel availability.

6.3 Active Care and Steady Care

Both tiers are month-to-month. No refunds are issued for partial months. To discontinue, provide 30 days’ written notice via your patient portal or email to denise@midlifemetabolicmedicine.com. Your final billing cycle will be the 30-day period following receipt of your notice.

6.4 Provider-Initiated Termination

If the provider initiates termination of the clinical relationship during the six-month clinical partnership (due to clinical safety concerns, development of a contraindication, loss of licensure in your state, or other circumstances in which the practice can no longer safely provide care), billing stops and you receive a refund of any months paid for but not yet started. You keep the monitoring kit. For Active Care and Steady Care, provider-initiated termination follows the same 30-day notice period as patient-initiated termination. Active prescriptions will be managed through the transition period as described in Section 11.

7. Program Pause Policy

The six-month clinical partnership allows for one pause of up to 30 days in the event of a medical issue, family emergency, or other significant life event. A pause extends your partnership end date by the length of the pause. For monthly billing, payments continue during a pause unless otherwise agreed in writing; for pay-in-full, a pause does not affect your payment. Please discuss any anticipated disruptions with your provider as early as possible.

Active Care and Steady Care do not have a formal pause policy. If you need to temporarily suspend services, provide written notice. Billing will continue until 30 days after receipt of your discontinuation notice. You may re-enroll at any time, subject to current panel availability.

8. Clinical Monitoring Kit

When you book the Metabolic Evaluation, you receive a clinical monitoring kit containing a Withings Body Smart scale, a Withings BPM Connect blood pressure cuff, and a Withings ScanWatch 2. The kit ships at booking, and device setup is your first task — a guided 10-minute setup connecting your devices to your patient portal so baseline data accumulates before your Review of Findings. The cost of the kit ($675) is absorbed into the partnership fee.

8.1 Ownership

The monitoring devices are yours to keep permanently, in every scenario, regardless of whether you continue care with this practice. Ownership transfers to you at the time of shipment.

8.2 Returns

Because the monitoring devices are personal health devices that are configured to your accounts and in contact with your body, they are non-returnable once shipped. If you cancel before your intake appointment after the kit has shipped, the kit cost ($675) is deducted from your refund as described in Section 6.1.

8.3 Replacement

If a device is defective or malfunctions within the manufacturer’s warranty period, we will assist you in obtaining a replacement through the manufacturer. Replacement of lost, stolen, or damaged devices beyond the warranty period is your responsibility.

8.4 Monitoring Data Review Scope

Review of your biometric device data is a deliverable of active paid care only. If you do not continue past month one, or while you are on the enrollment waitlist, the data pipeline into your clinical record is paused and no standing provider review occurs. Your devices remain your property and continue to function as consumer devices. No ongoing provider monitoring occurs outside an active care tier.

9. Telehealth Informed Consent

All clinical services are delivered via telehealth. Prior to your first clinical visit, you will be asked to provide informed consent to receive services via telehealth. This consent covers the delivery method, the security measures in place to protect your health information, the potential for information loss due to technical failures, your right to discontinue telehealth at any time and request an alternative (in-person) referral, and the limitations inherent in telehealth. Informed consent is obtained and documented through Practice Better in compliance with Idaho’s Virtual Care Access Act (IDAPA 24.33.03.205) and Oregon telehealth consent requirements.

If you indicate at any point that you wish to stop using telehealth, the service will cease, and we will assist you in finding an appropriate in-person provider if available.

10. Medication and Prescribing

Medications, including GLP-1 receptor agonists (semaglutide, tirzepatide), metformin, bioidentical hormone replacement therapy, and thyroid medications, are prescribed only when clinically indicated based on your laboratory results, metabolic profile, and clinical history. We do not guarantee that any specific medication will be prescribed. All prescriptions are transmitted electronically.

Our provider holds full independent prescriptive authority in both Oregon and Idaho, including authority to prescribe legend drugs and controlled substances in Schedules II through V, with active DEA registration. Idaho grants NPs full independent practice and prescriptive authority under Idaho Admin. Code §24.34.01. Oregon similarly authorizes NPs to prescribe legend drugs and Schedules II–V controlled substances under ORS 678.390 and OAR 851-056. No physician supervision or collaborative agreement is required in either state.

All controlled substance prescribing complies with applicable federal DEA regulations, Idaho Board of Pharmacy requirements, and Oregon Board of Pharmacy requirements, including Prescription Drug Monitoring Program (PDMP) obligations. Oregon requires PDMP checks prior to prescribing Schedule II–IV controlled substances and at least every 90 days for ongoing prescriptions (ORS 435.405); this is a universal prescribing requirement, not a telehealth-specific restriction.

Neither Oregon nor Idaho imposes a state-level telehealth-specific restriction on controlled substance prescribing beyond federal law. Idaho Code § 54-5706 permits controlled substance prescribing via telehealth in compliance with 21 U.S.C. § 802(54)(A), deferring to the federal standard. Oregon similarly permits Schedule II–V prescribing via telehealth provided a valid provider-patient relationship is established and an appropriate medical evaluation has been conducted. Neither state requires an initial in-person visit before prescribing controlled substances via telehealth. At the federal level, DEA telemedicine flexibilities permitting Schedule II–V prescribing without an initial in-person examination have been extended through December 31, 2026. When a permanent federal rule replaces these flexibilities, both states will operate under the updated federal standard.

Medication costs are your responsibility and are separate from all program and membership fees. Prescriptions are transmitted electronically to the pharmacy appropriate for your prescription; pharmacy selection and billing arrangements vary by medication and are discussed with you individually. We do not guarantee insurance coverage, prior authorization approval, or availability of any specific medication.

11. Provider-Patient Relationship

The provider-patient relationship is established at the time of the Metabolic Evaluation intake appointment, not at the Discovery Visit. The Discovery Visit is an introductory conversation only and does not constitute a clinical evaluation, diagnosis, or treatment.

MMM is a solo provider practice. Your care is delivered by Denise Erland, FNP-C. In the event that the provider is temporarily unavailable (illness, vacation, personal leave), scheduled visits will be rescheduled and messaging response times may be extended. MMM does not provide coverage by a substitute provider during temporary absences. For patients on active medication regimens (including GLP-1 receptor agonists, hormone replacement therapy, and thyroid medications), the provider will ensure that prescriptions are current and sufficient to cover the anticipated absence period before the absence begins. If an unanticipated absence extends beyond 14 days, patients on active medications will be contacted with instructions for obtaining interim prescriptions through their primary care provider or an urgent care facility. In the event of a medical emergency while your provider is unavailable, contact 911 or your nearest emergency department.

Either party may terminate the provider-patient relationship. If the provider determines that the practice is no longer able to meet your clinical needs, we will provide a minimum of 30 days’ written notice and assist with transition to another provider, including providing your medical records and, for patients on active medication regimens, ensuring that prescriptions are sufficient to cover the transition period or facilitating transfer of prescribing responsibility to your primary care provider or a receiving provider. Patient-initiated termination follows the discontinuation and refund procedures described in Sections 6 and 7. Financial remedies for provider-initiated termination during the six-month clinical partnership are described in Section 6.4.

In the event that the provider becomes permanently unable to practice (due to death, permanent disability, loss of licensure, or practice closure), the practice will make reasonable efforts to notify all active patients, facilitate transfer of medical records to each patient’s designated provider, and issue prorated refunds for any pre-paid program fees for services not yet rendered. The provider has designated a clinical colleague to facilitate patient record transfers and care transitions in such circumstances. Active patients’ medical records will be retained and made available in accordance with Oregon and Idaho medical record retention requirements. Neither Oregon statute nor Oregon Board of Nursing rules, nor Idaho statute nor Idaho Board of Nursing rules, mandate a formal written succession plan for a solo healthcare practice. However, patient abandonment standards in both states require that patients not be left without reasonable notice and opportunity to secure alternative care. A designated clinical colleague arrangement — documented in a written agreement with the colleague’s consent, addressing record access, patient notification, medication continuity, and refund processing authority — meets the standard of care for a prudent solo practitioner in both jurisdictions, even though it is not statutorily required. Oregon SB 951 (2025), which addresses succession agreements for physician practices with MSO affiliations, does not apply to solo NP PLLCs without MSO relationships.

12. Standard of Care and Limitations

All services are provided in accordance with the applicable standard of care for nurse practitioner practice in Oregon and Idaho, as required by the Idaho Virtual Care Access Act and Oregon telehealth regulations. Telehealth services are held to the same standard of care as in-person services.

MMM does not guarantee specific health outcomes, including specific amounts of weight loss, specific lab result changes, or resolution of any medical condition. Individual results vary based on adherence, genetics, comorbid conditions, medication response, and other factors outside the provider’s control. The care we provide is evidence-informed and individually tailored, but no outcome is guaranteed.

13. Communication

All clinical communication occurs through your HIPAA-compliant patient portal in Practice Better. We do not conduct clinical communication via standard email, text message, or social media. Our guaranteed messaging response time is 48 business hours. Member office hours are available by appointment — twice per week during the Metabolic Rebuild and weekly on Active Care and Steady Care. The weekly Metabolic Lab group session is described in Section 4.7.

Marketing communications (email newsletters, educational content) are sent through HubSpot and are separate from clinical communications. You may opt out of marketing communications at any time without affecting your clinical care.

14. Medical Records

Your medical records are maintained in Practice Better. You have the right to access and obtain a copy of your medical records at any time. Records requests should be directed to denise@midlifemetabolicmedicine.com. Medical records are retained in accordance with Oregon and Idaho state medical record retention requirements. We will not withhold access to your medical records due to an outstanding account balance.

15. Governing Law and Dispute Resolution

This Services Policy is governed by the laws of the State of Idaho.

15.1 Mediation

Before initiating any legal proceeding arising out of or relating to services provided under this policy, the parties agree to attempt resolution through good-faith mediation. Either party may initiate mediation by providing written notice to the other party. The parties will mutually select a mediator within 30 days of the notice. Mediation costs will be shared equally. Mediation is a prerequisite to filing any court action, except in cases requiring emergency or injunctive relief.

15.2 Jurisdiction and Venue

If mediation does not resolve the dispute, either party may pursue the matter in court. For disputes involving patients located in Idaho at the time of the disputed services, or for any non-clinical dispute (including billing, refund, or policy interpretation disputes regardless of patient location), venue shall be in the state or federal courts of Ada County, Idaho. For disputes involving clinical care claims by patients located in Oregon at the time of the disputed services, venue shall be in the state or federal courts of the State of Oregon in the county where the patient was located at the time of the disputed services, applying Oregon law to the clinical care claims.

15.3 Professional Liability

Nothing in this Section limits or modifies the terms of any professional liability or malpractice insurance policy covering the provider. In the event of any conflict between this dispute resolution clause and the requirements of the provider’s professional liability carrier, the carrier’s requirements shall govern.

15.4 Acknowledgment

By enrolling in any clinical program or membership, you acknowledge that you have read and understand this dispute resolution provision. This provision is intended to be separate from, and independently enforceable from, the remainder of this Services Policy.

16. Changes to This Services Policy

We may update this Services Policy from time to time to reflect changes in our services, pricing, legal requirements, or operational procedures. When we make material changes, we will update the “Last Updated” date at the top of this page and notify active patients through the patient portal. Material changes to pricing or refund terms will not apply retroactively to patients currently enrolled in a program or membership at the time of the change.

17. Contact Information

If you have questions about this Services Policy, please contact us:

Denise Erland, FNP-C

Midlife Metabolic Medicine, 1350 S Five Mile Rd, Unit 190544, Boise, ID 83719

denise@midlifemetabolicmedicine.com