Phillip C

Phillip C. Gioia, MD, MPH, FAAP, FACPM May

Health Central, Suite 201, Auburn, NY 13021 2007

phone 315 253 6257 fax 315 253 8693

http://pages.prodigy.net/pcgioia

Adaptive Living Services

$105 Initial Consult for 30 minutes to discuss what we offer to help you live better for less cost.

$210 Hourly fee for individual, family or group consultation to help you live adaptively: to enjoy life more and conserve your resources. Recommended pre-conception, pre-birth, pre-teen, and pre-death. May gather history and do education.

$240 Annual fee to maintain up to 20 pages of medical records. Recommended Health Care Proxy, Living Will, Medical Care Summary or CCR (Continuity of Care Record), and medication list. Includes access by paper copy or digital floppy disc copy once a year at our office during regular office hours or by mail. Further access or faxing or mailing $40 per request.

$240 Retainer Fee for access to your 20 pages or less of medical records 24 hours a day for 7 days a week by fax or secure e-mail. $60 charge for each request.

$240 Retainer Fee for access to Dr. Gioia by phone or e-mail to consult on adaptive living and how to use health and medical resources. $60 charge for up to 10 minutes of phone consultation or one e-mail. $60 charged for each 10 minute or less time interval beyond 10 minutes. Available 24/7.

All fees should be paid prior to service and missed appointments will be charged for at the usual rate.

We recommend that you also have a primary care doctor to take care of your immediate medical needs.

We will concentrate on your long term needs and coordination of health and medical care.

Your records will be shared or kept private according to your wishes and your funding of your information services. As long as you avoid asking for insurance payments we may keep your records private from anyone according to your wishes and Federal and State Law.

I, ____________________, understand that Phillip Gioia, MD, MPH through his Adaptive Living Service will only advise me and my family on how to live better while conserving resources. He or his Service may recommend medical care or treatments but he and his Service will depend on me and my physician to deliver the medical service; and I have or will soon try to get a primary care physician.

Signed ________________________________