Free printable checklist
Four questions before choosing a program
Take these four questions to the provider before paying. Print a copy or save as PDF from your browser.
Provider and exact plan: ____________________________________ Date checked: ______________
- 1
What will I pay today?
Record the actual checkout charge, period covered, and any medication, visit, membership, shipping or laboratory fee billed separately.
- 2
How long am I committed?
Record the plan length and any remaining payment obligations. Monthly payments do not automatically mean a one-month commitment.
- 3
What happens at renewal or cancellation?
Record the next charge, billing date, cancellation deadline and confirmation process. Note what is refundable before and after prescription or shipping.
- 4
What service is included?
Check medication category, clinician involvement, follow-up, messaging and state availability. Ask the clinician about suitability and risks; this is a billing checklist, not treatment advice.