Last Updated: [December 15th, 2025 ]
Initial consult visit
$150 one time fee
Premium membership
$100/month
Basic membership
$50/month
FDA approved Tirzepatide
- With insurance – potentially as low as $25/month
- Without insurance thru the Zepbound Self Pay Journey Program via Eli Lilly
- 2.5mg – $299/month (4 vials)
- 5mg – $399/month (4 vials)
- 7.5-15mg – $449/month (4 vials)
- Standard price for a 1- month supply is $599 for 7.5 mg, $699 for 10 mg, $849 for 12.5 mg, and $1,049 for 15 mg – we don’t recommend
- *** These costs are paid directly to Eli Lilly, we do not profit on any of the costs of medication
1. Purpose and Scope
This agreement explains your financial responsibility for any medical or wellness services provided by KZ Wellness, PLLC (“KZ Wellness, PLLC,” “we,” “our,” “us”) on a fee-for-service basis.
It applies to any patient who:
- is not enrolled in the monthly membership program; or
- receives a service not included in the membership (for example, initial consult visit, medication cost, behavioral health therapy).
2. Self-Pay Status
KZ Wellness, PLLC is a cash-pay telehealth clinic.
We do not bill or accept private insurance, Medicare, or Medicaid.
By signing this agreement, you acknowledge that all services rendered by KZ Wellness, PLLC are self-pay and that you are financially responsible for all charges.
3. Disclosure of Fees
You will be informed of the service fee before each appointment.
4. Non-Covered Costs
The following items are not included in the service fee and remain your responsibility:
- Prescription medication costs (including GLP-1 / GIP medications).
- Laboratory or diagnostic testing.
- Medical devices, supplies, or supplements.
- Third-party pharmacy or laboratory fees.
- Any products or services provided by outside entities including behavioral health therapy through The Shoreline Therapy Center.
KZ Wellness, PLLC does not guarantee that these costs are reimbursable by insurance, Health Savings Accounts (HSA), or Flexible Spending Accounts (FSA).
5. Payment Terms
- Payment Due: At the time of booking or service delivery.
- Accepted Methods: Credit or debit card via Stripe (our secure payment processor).
- Authorization: By signing this agreement, you authorize KZ Wellness, PLLC to charge the card you provide through Stripe for all services rendered.
- Receipts: An electronic receipt will be provided upon processing.
6. Refund and Cancellation Policy
- Appointments canceled ≥ 24 hours in advance: 100% refund or reschedule without penalty.
- Appointments canceled < 24 hours in advance or no-shows: determined on a case to case basis.
- Refunds are not issued once a consultation has been completed or clinical advice provided.
- Refunds for duplicate or erroneous charges will be issued promptly upon verification.
7. Collections and Unpaid Balances
If payment is not received, KZ Wellness, PLLC may:
- charge any valid card on file;
- suspend future services; or
- refer the balance to a licensed collections agency.
You agree to pay reasonable collection costs, interest, and attorney’s fees as permitted by law.
8. Telehealth Compliance (Connecticut)
You acknowledge that KZ Wellness, PLLC provides services through telehealth in compliance with Connecticut General Statutes § 19a-906 and applicable federal HIPAA regulations.
All telehealth interactions occur while you are physically located in a state where the provider is licensed (Connecticut).
You will not record any telehealth sessions without written consent from your provider.
9. Privacy and Security
Your personal and health information will be protected according to HIPAA and our Notice of Privacy Practices.
Payments are processed through Stripe, which complies with the Payment Card Industry Data Security Standard (PCI-DSS).
10. Acknowledgment and Consent
By signing below, you acknowledge that:
- You have read, understood, and agree to this Fee-for-Service & Financial Responsibility Agreement.
- You understand KZ Wellness, PLLC does not bill insurance and that you are personally responsible for all fees.
- You authorize KZ Wellness, PLLC to charge your payment method for agreed-upon services.
