Texas Diabetes & Wellness Clinic

Diabetes Doctor
Membership Plan

"Dr. Jaffer — It's rare to find a doctor that cares."

First Month: $100 Then: $59/month Doctor Visits: $25 Cancel Anytime
$100
First Month
$59
Per Month Thereafter
$25
Doctor Visit Co-Pay
$50
Blood Work (after 1st visit)
$99
Cancellation Fee

Membership Benefits

Quality diabetes care without the insurance hassle. No insurance? No problem.

Doctor Visits
See Dr. Jaffer every 3 months or earlier as medically appropriate.
$25 co-pay
In-House Blood Work
First visit $100 — all subsequent blood work at member pricing.
$50 thereafter
Gifts & Merchandise
Receive $20 worth of gifts or merchandise at every visit.
$20 every visit
Monthly Nurse Check-In
A nurse calls you every month between appointments for refills, questions, and support.
Included
Priority Same-Day Appointments
Members get priority weekday scheduling, subject to availability.
Included
Dietitian Consultation
In-house dietitian access at a steep member discount.
$25 (reg. $75)

Compare Your Benefits

See exactly how much you save as a member.

Service / Benefit Without Membership With Membership
Doctor Visit$100$25
Blood Work$100$50
Dietitian Consultation$75$25
Gifts / MerchandiseNot included$20 every visit
Priority Same-Day Weekday Appt
Refills Between Visits
Monthly Nurse Check-In
Sample Medication (when available)Free when available
Membership FeeNone$100 first month; $59/mo
Weight Loss Services
Weight Loss Consultation$100$25
Monthly Follow-Up for Weight Loss$50$25
GLP-1 MedicationNo discount10% off

Simple Month-to-Month Care

1
Sign Up & Pay
Complete the membership form below. First month is $100, then $59/month billed automatically.
2
See Dr. Jaffer
Schedule your visit — just $25 co-pay. We see you every 3 months or earlier as needed.
3
Monthly Nurse Call
Between visits, a nurse checks in for refills, questions, and any health concerns.
4
Cancel Anytime
No long contracts. Cancel with written notice plus a $99 cancellation fee at any time.

Month-to-Month Membership Agreement

Complete the form below and a team member will contact you within 1 business day to finalize enrollment and process your first payment.

Membership Enrollment & Agreement

Texas Diabetes & Wellness Clinic · 21720 Highland Knolls Dr, Katy, TX 77450 · (713) 581-4237

Application Received!

Thank you for joining TDWC. Our team will contact you within 1 business day to complete your enrollment and process your first payment of $100.

Patient Information
Emergency Contact
Membership Agreement

1. Plan Type & Fees

This is a Month-to-Month Diabetes Membership Agreement with Texas Diabetes & Wellness Clinic. This is a direct-pay membership — it is not health insurance and is not a substitute for health insurance. First month membership fee: $100. Monthly fee thereafter: $59/month, billed automatically until cancelled. Doctor visit co-pay: $25. Blood work: first visit $100; thereafter $50. Dietitian consultation: $25. Weight loss consultation: $50. Monthly weight loss follow-up: $25. GLP-1 discount: 10% off when available. Medication is not included in the membership fee.

2. Services & Benefits

Doctor visits every 3 months or earlier at provider discretion. Monthly nurse check-in call. Refill assistance between visits when medically appropriate — refills are not guaranteed. Priority same-day weekday appointments, subject to availability. Sample medication may be available for free occasionally — not guaranteed. Access to in-house lab and dietitian consultation.

3. Services Not Included

Prescription medications, GLP-1 medications, medical supplies, CGMs, pumps, test strips, durable medical equipment, ER care, hospital services, inpatient care, specialist care outside the Clinic, imaging, outside lab fees, procedures, or services not listed in this Agreement.

4. Cancellation

You may cancel by written notice to the Clinic. A $99 cancellation fee plus any unpaid balance is due upon cancellation. The Clinic may terminate membership for non-payment, misuse, abusive conduct, or repeated missed appointments.

5. Payment Authorization

You authorize TDWC to keep your payment method on file and charge recurring membership fees, visit co-pays, blood work, dietitian fees, cancellation fees, and any other amounts owed under this Agreement.

6. Medical Disclaimer

All services, medications, refills, and treatment plans are subject to provider judgment and medical appropriateness. The Clinic does not guarantee any diagnosis, prescription, weight loss, lab result, or health outcome.

7. Governing Law

This Agreement is governed by Texas law. This membership is personal and non-transferable. This is the entire understanding regarding the membership plan unless a separate writing is signed by both parties.
Acknowledgments & Consents
Payment Card on File
Do not enter your full card number here. A team member will securely collect your full payment details by phone or in-person to set up the recurring charge. Provide only the last 4 digits and card type below so staff can verify the card on file.
Electronic Signature

By typing your name above you agree this constitutes your legal electronic signature on this Membership Agreement.

Our team will call or email you within 1 business day to complete enrollment and process your $100 first-month payment.

Important Information

  • This membership plan is not health insurance and is not a substitute for health insurance.
  • Membership covers only the listed clinic services and benefits.
  • Medications, medical supplies, specialist care, imaging, hospital care, and outside lab fees are not included.
  • All care, follow-up, timing, refills, and services are subject to provider discretion, medical appropriateness, and scheduling availability.
  • Same-day weekday appointments are subject to availability.
  • Nurse follow-up calls are for non-emergency support only. In a medical emergency, call 911 or go to the nearest emergency room.
  • Pricing, terms, and membership details may change. Ask the clinic for full terms and current details.
  • Cancellation is allowed with a $99 cancellation fee.