Last revision: June 14, 2019
Use of the Site.
The Healthcare Professionals who deliver Services through Choices Family Medical Clinic are compliant with the requirements applicable to his or her profession and license.
None of the Site content (other than information you receive from Healthcare Professionals) should be considered medical advice or an endorsement, representation or warranty that any particular medication or treatment is safe, appropriate, or effective for you.
When you register on the Site, you are required to enter your name, email address, and certain other information collected by Choices Family Medical Clinic (collectively “Account Information”). To create an Account, you must be of legal age to form a binding contract. If you are not of legal age to form a binding contract, you may not register to use our Services. You agree that the Account Information that you provide to us at all times, including during registration and in any information you upload to the Site, will be true, accurate, current, and complete. You may not transfer or share your Account password with anyone, or create more than one Account (with the exception of subaccounts established for children of whom you are the parent or legal guardian). You are responsible for maintaining the confidentiality of your Account password and for all activities that occur under your Account. Choices Family Medical Clinic reserves the right to take any and all action, as it deems necessary or reasonable, regarding the security of the Site and your Account Information. In no event and under no circumstances shall Choices Family Medical Clinic be held liable to you for any liabilities or damages resulting from or arising out of your use of the Site, your use of the Account Information or your release of the Account Information to a third party. You may not use anyone else's account at any time.
Use of the Services by Children.
Fees and Purchase Terms.
You agree to pay all fees or charges to your Account in accordance with the fees, charges, and billing terms in effect at the time a fee or charge is due and payable. By providing Choices Family Medical Clinic with your credit card number or PayPal account and associated payment information, you agree that Choices Family Medical Clinic is authorized to immediately invoice your account for all fees and charges due and payable to Choices Family Medical Clinic hereunder and that no additional notice or consent is required. If your health plan, employer or agency has arranged with Choices Family Medical Clinic to pay the fee or any portion of the fee, or if the fee is pursuant to some other arrangement with Choices Family Medical Clinic, that fee adjustment will be reflected in the fee that you are ultimately charged. Please check with your employer, health plan or agency to determine if any Services will be reimbursed.
WE WILL NOT BE LIABLE FOR ANY INFORMATION, SOFTWARE, OR LINKS FOUND AT ANY OTHER WEBSITE, INTERNET LOCATION, OR SOURCE OF INFORMATION, NOR FOR YOUR USE OF SUCH INFORMATION, SOFTWARE OR LINKS, NOR FOR THE ACTS OR OMISSIONS OF ANY SUCH WEBSITES OR THEIR RESPECTIVE OPERATORS.
Certain of the names, logos, and other materials displayed on the Site or in the Services may constitute trademarks, trade names, service marks or logos ("Marks") of Choices Family Medical Clinic or other entities. You are not authorized to use any such Marks without the express written permission of Choices Family Medical Clinic. Ownership of all such Marks and the goodwill associated therewith remains with us or those other entities.
You may discontinue your Account and end your registration at any time, for any reason by sending an email to firstname.lastname@example.org. Choices Family Medical Clinic may suspend or terminate your use of the Site, your Account and/or registration for any reason at any time. Subject to applicable law, Choices Family Medical Clinic reserves the right to maintain, delete or destroy all communications and materials posted or uploaded to the Site pursuant to its internal record retention and/or content destruction policies. After such termination, Choices Family Medical Clinic will have no further obligation to provide the Services, except to the extent we are obligated to provide you access to your health records or Healthcare Professionals are required to provide you with continuing care under their applicable legal, ethical and professional obligations to you.
Right to Modify.
DISCLAIMER OF WARRANTIES.
YOU EXPRESSLY AGREE THAT USE OF THE SITE OR SERVICES IS AT YOUR SOLE RISK. BOTH THE SITE AND SERVICES ARE PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS. CHOICES FAMLY MEDICAL CLINC EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR USE OR PURPOSE, NON-INFRINGEMENT, TITLE, OPERABILITY, CONDITION, QUIET ENJOYMENT, VALUE, ACCURACY OF DATA AND SYSTEM INTEGRATION.
LIMITATION OF LIABILITY.
YOU UNDERSTAND THAT TO THE EXTENT PERMITTED UNDER APPLICABLE LAW, IN NO EVENT WILL CHOICES FAMILY MEDICAL CLINIC OR ITS OFFICERS, EMPLOYEES, DIRECTORS, PARENTS, SUBSIDIARIES, AFFILIATES, AGENTS OR LICENSORS BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR EXEMPLARY DAMAGES, INCLUDING BUT NOT LIMITED TO, DAMAGES FOR LOSS OF REVENUES, PROFITS, GOODWILL, USE, DATA OR OTHER INTANGIBLE LOSSES ARISING OUT OF OR RELATED TO YOUR USE OF THE SITE OR THE SERVICES, REGARDLESS OF WHETHER SUCH DAMAGES ARE BASED ON CONTRACT, TORT (INCLUDING NEGLIGENCE AND STRICT LIABILITY), WARRANTY, STATUTE OR OTHERWISE.
To the extent that we may not, as a matter of applicable law, disclaim any implied warranty or limit its liabilities, the scope and duration of such warranty and the extent of our liability will be the minimum permitted under such applicable law.
Choices Family Medical Clinic makes no representation that all products, services and/or material described on the Site, or the Services available through the Site, are appropriate or available for use in locations outside the United States or all territories within the United States.
All Health Professionals on the Site hold professional licenses issued by the professional licensing boards in the states where they practice. All physician and nurse practitioners hold advanced degrees in medicine and have undergone postgraduate training. You can report a complaint relating to the care provided by a Healthcare Professional by contacting the professional licensing board in the state where the care was received. In a professional relationship, sexual intimacy is never appropriate and should be reported to the board or agency that licenses, registers, or certifies the licensee.
You can find the contact information for each of the state professional licensing boards governing medicine on the Federation of State Medical Boards website at http://www.fsmb.org/state-medical-boards/contacts.
Any clinical records created as a result of your use of the Services will be securely maintained by Choices Family Medical Clinic for a period that is no less than the minimum number of years such records are required to be maintained under state and federal law, and which is typically at least six years.
Choices Family Medical Clinic devotes considerable effort to optimizing signal strength and diagnosis deficiencies but is not responsible for the internet or data bandwidth and signal of your mobile device.
The Digital Millennium Copyright Act of 1998 (the "DMCA") provides recourse for copyright owners who believe that material appearing on the Internet infringes their rights under U.S. copyright law. If you believe in good faith that materials appearing on the Site infringe your copyright, you (or your agent) may send us a notice requesting that the material be removed, or access to it blocked. In addition, if you believe in good faith that a notice of copyright infringement has been wrongly filed against you, the DMCA permits you to send us a counter-notice. Notices and counter-notices must meet statutory requirements imposed by the DMCA. One place to find more information is the U.S. Copyright Office Web site, currently located at http://www.loc.gov/copyright. In accordance with the DMCA, Choices Family Medical Clinic has designated an agent to receive notification of alleged copyright infringement in accordance with the DMCA. Any written Notification of Claimed infringement should comply with Title 17, United States Code, Section 512(c)(3)(A) and should be provided in writing to Choices Family Medical Clinic 6659 Sullivan Road, Greenwell Springs, LA 70739.
Informed Consent Agreement
Description of Services.
The Healthcare Professionals at Choices Family Medical Clinic provide healthcare services using interactive audio and video technologies where you and the Healthcare Professional are not in the same physical location. You can form an ongoing treatment relationship with a Healthcare Professional, however, your initial visit may begin as a consultation (e.g. to determine the most appropriate treatment setting for you to receive care) and will not necessarily give rise to an ongoing treatment relationship. You should seek emergency help or follow-up care when recommended by a Healthcare Professional or when otherwise needed, and continue to consult with your other healthcare providers as recommended. Among the benefits of our Services are improved access to healthcare and convenience. However, as with any health service, there are potential risks associated with the use of technology.
These risks include, but may not be limited to:
o In rare cases, information transmitted may be insufficient for healthcare decision making.
o Disruptions can occur due to failures of the electronic equipment or internet connection. If this happens, you may be contacted by phone or other means of communication.
o In rare cases, a lack of access to all of your health records may result in adverse drug interactions or other errors.
o Although we incorporate strong security protocols to protect the confidentiality of your health information, in rare instances security protocols can fail, causing a breach of confidentiality.
By accepting this consent you acknowledge that you understand and agree with the following:
o If your health insurance coverage does not pay for your Services charges in full, you may be fully or partially responsible for payment.
o We may determine that our clinical services are not appropriate for some or all of your treatment needs and may elect not to provide clinical services to you through the Site.
o With respect to psychotherapy, you are entitled to receive information from your Healthcare Professional about the methods of therapy, the techniques used, the duration of your therapy (if known), and the fee structure. You can seek a second opinion from another therapist or terminate therapy at any time.
o You attest that you have legal authority to act as guardian or personal representative of all children registered under your Account.
o No results can be guaranteed or assured.
If you and a Healthcare Professional decide to engage in group or couples therapy (collectively “Group Therapy”), you understand that information discussed in Group Therapy is for therapeutic purposes and is not intended for use in any legal proceedings involving Group Therapy participants. You agree not to subpoena the Healthcare Professional to testify for or against other Group Therapy participants or provide records in court actions against other Group Therapy participants. You understand that anything any Group Therapy participant tells the Healthcare Professional individually, whether on the phone or otherwise, may at the therapist’s discretion be shared with the other Group Therapy participants. You agree to share responsibility with the Healthcare Professional for the therapy process, including goal setting and termination.
You can send messages to a Healthcare Professional by contacting our Member Support team at 1-800-256-3947. Emails or electronic messages to Member Support or a Healthcare Professional may not be returned immediately. If you are experiencing a medical emergency, you should call 911 or go to the nearest emergency room.
1. Notice of Health Information Privacy Practices .
How is patient privacy protected?
As the healthcare professionals providing online medical services through Choices Family Medical Clinic (the “Healthcare Professionals”, “us”, “we”, “our”), we understand that information about you and your health is personal. Because of this, we strive to maintain the confidentiality of your health information. We continuously seek to safeguard that information through administrative, physical and technical means, and otherwise abide by applicable federal and state guidelines.
How do we use and disclose health information?
We use and disclose your health information for the normal business activities that the law sees as falling in the categories of treatment, payment and healthcare operations. Below we provide examples of those activities, although not every use or disclosure falling within each category is listed:
· Treatment – We keep a record of the health information you provide us. This record may include your test results, diagnoses, medications, your response to medications or other therapies, and information we learn about your medical condition through the online Services. We may disclose this information so that other doctors, nurses, and entities such as laboratories can meet your healthcare needs.
· Payment – We document the services and supplies you receive when we are providing care to you so that you, your insurance company or another third party can pay us. We may tell your health plan about upcoming treatment or services that require prior approval by your health plan.
· Health care Operations – Health information is used to improve the services we provide, to train staff, for business management, quality assessment and improvement, and for customer service. For example, we may use your health information to review our treatment and services and to evaluate the performance of our staff in caring for you.
We may also use your health information to:
· Comply with federal, state or local laws that require disclosure.
· Assist in public health activities such as tracking diseases or medical devices.
· Inform authorities to protect victims of abuse or neglect.
· Comply with Federal and state health oversight activities such as fraud investigations.
· Respond to law enforcement officials or to judicial orders, subpoenas or other process.
· Inform coroners, medical examiners and funeral directors of information necessary for them to fulfill their duties.
· Facilitate organ and tissue donation or procurement.
· Conduct research following internal review protocols to ensure the balancing of privacy and research needs.
· Avert a serious threat to health or safety.
· Assist in specialized government functions such as national security, intelligence and protective services.
· Inform military and veteran authorities if you are an armed forces member (active or reserve).
· Inform a correctional institution if you are an inmate.
· Inform workers’ compensation carriers or your employer if you are injured at work.
· Recommend treatment alternatives.
· Tell you about health-related products and services.
· Communicate within our organization for treatment, payment, or healthcare operations.
· Communicate with other providers, health plans, or their related entities for their treatment or payment activities, or health care operations activities relating to quality assessment and improvement, care coordination and the qualifications and training of healthcare professionals;
· Provide information to other third parties with whom we do business, such as a record storage provider. However, you should know that in these situations, we require third parties to provide us with assurances that they will safeguard your information.
· We may also use or disclose your personal or health information for operational purposes. For example, we may communicate with individuals involved in your care or payment for that care, such as friends and family and send appointment reminders.
All other uses and disclosures, not previously described, may only be done with your written authorization. We will also obtain your authorization before we use or disclose your health information for marketing purposes or before we would sell your information. You may revoke your authorization at any time; however, this will not affect prior uses and disclosures. In some cases state law may require that we apply extra protections to some of your health information.
What are the Healthcare Professional’s Responsibilities?
We are required by law to:
· Maintain the privacy of your health information.
· Provide this Notice of our duties and privacy practices.
· Abide by the terms of the Notice currently in effect.
· Tell you if there has been a breach that compromises your health information.
We reserve the right to change our privacy practices, and make the new practices effective for all the information we maintain. Revised notices will be posted on the Choices Family Medical Clinic website and mobile application.
Do you have any Federal Rights?
The law entitles you to:
· Inspect and copy certain portions of your health information. We may deny your request under limited circumstances. You may request that we provide your health records to you in an electronic format.
· Request amendment of your health information if you feel the health information is incorrect or incomplete. However, under certain circumstances we may deny your request.
· Receive an accounting of certain disclosures of your health information made for the prior six (6) years, although this excludes disclosures for treatment, payment, and health care operations. (Fees may apply to this request).
· Request that we restrict how we use or disclose your health information. However, we are not required to agree with your requests, unless you request that we restrict information provided to a payor, the disclosure would be for the payor’s payment or healthcare operations, and you have paid for the health care services completely out of pocket.
· Request that we communicate with you at a specific telephone number or address.
· Obtain a paper copy of this notice even if you receive it electronically.
We may ask that you make some of these requests in writing.
What if I have a Complaint?
If you believe that your privacy has been violated, you may file a complaint with us or with the Secretary of Health and Human Services in Washington, D.C. We will not retaliate or penalize you for filing a complaint with the facility or the Secretary. To file a complaint with us or receive more information contact:
Phone: (800) 256-3947
Address: 6659 Sullivan Road Greenwell Springs, LA 70739
· To file a complaint with the Secretary of Health and Human Services write to 200 Independence Ave., S.E., Washington, D.C. 20201, call 1-800-537-7697, or file an online complaint at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf.
Who Will Follow This Notice?
This Notice describes the health care practices of:
· Any Healthcare Professional authorized to access and/or enter information into your health record;
· All departments and units through which Choices Family Medical Clinic online health services are provided; and
· All affiliates and volunteers.
Children under age 18.
We do not knowingly allow individuals under the age 18 to create Accounts that allow access to our Site.
The Personal information we collect or maintain may include:
· Your name, age, email address, username, password, and other registration information.
· Health Information that you provide us, which may include information or records relating to your medical or health history, health status and laboratory testing results, diagnostic images, and other health related information.
· Health information about you prepared or obtained by the Healthcare Professionals(s) who provide clinical services through the Site such as medical and therapy records, treatment and examination notes, and other health related information.
· Billing information that you provide us, such as credit card information.
· Information about the computer or mobile device you are using, such as what Internet browser you use, the kind of computer or mobile device you use, and other information about how you use the Site.
· Other information you input into the Site or related services.
We may use your Personal Information for the following purposes (subject to the restrictions relating to the use of Health Information described in Section I):
· To provide you with the Services.
· To improve healthcare quality through the performance of quality reviews and similar activities.
· To create De-identified Information such as aggregate statistics relating to the use of the Services.
· To notify you when Site updates are available.
· To market and promote the Site and the Services to you.
· To fulfill any other purpose for which you provide us Personal Information.
· For the purposes described in Section I relating to the use of Health Information.
· For any other purpose for which you give us authorization.
We may also disclose Personal Information that we collect or you provide (subject to the restrictions relating to the use of Health Information described in Section I):
· To our subsidiaries and affiliates.
· To contractors, service providers and other third parties we use to support our business and who are bound by contractual obligations to keep personal information confidential and use it only for the purposes for which we disclose it to them.
· As required by law, which can include providing information as required by a court order.
· When we believe in good faith that disclosure is necessary to protect your safety or the safety of others, to protect our rights, to investigate fraud, or to respond to a government request.
· To a buyer or other successor in the event of a merger, divestiture, restructuring, reorganization, dissolution or other sale or transfer of some or all of Choices Family Medical Clinic's assets, whether as a going concern or as part of bankruptcy, liquidation or similar proceeding, in which Personal Information maintained by the Site is among the assets transferred.
· For any other purpose disclosed by us when you provide the information.
Information We Collect via Technology.
As you use the Site or the Services, certain information may be passively collected by Cookies, navigational data like Uniform Resource Locators (URLs) and third party tracking services, including:
· Site Activity Information. We may keep track of some of the actions you take on the Site, such as the content of searches you perform on the Site.
· Access Device and Browser Information. When you access the Site from a computer or other device, we may collect anonymous information from that device, such as your Internet protocol address, browser type, connection speed and access times (collectively, “Anonymous Information”).
· Cookies. We may use both session Cookies (which expire once you close your web browser) and persistent Cookies to make the Site and Services easier to use, to make our advertising better, and to protect both you and Choices Family Medical Clinic. You can instruct your browser, by changing its options, to stop accepting Cookies or to prompt you before accepting a Cookie from the websites you visit. If you do not accept Cookies, however, you will not be able to stay logged in to the Site. We presently do not honor "Do Not Track" requests across all parts of our Site.
· Real-Time Location. Certain features of the Site use GPS technology to collect real-time information about the location of your device so that the Site can connect you to a Healthcare Professional who is licensed or authorized to provide Services in the state where you are located.
· Mobile Services. We may collect non-personal information from your mobile device or computer. This information is generally used to help us deliver the most relevant information to you. Examples of information that may be collected and used include how you use the application(s) and information about the type of device or computer you use. In addition, in the event our application(s) crashes on your mobile device we will receive information about your mobile device model software version and device carrier, which allows us to identify and fix bugs and otherwise improve the performance of our application(s).
We may use De-Identified Information created by us without restriction.
Information You Share With Third Parties.
Modification of Information.
Members will be able to update some of their information through the Site. Requests to modify any information may also be submitted to email@example.com.
· Limitations on Deletion of Information.
Steps we take to keep your information secure.
We employ reasonable physical, electronic and managerial security methods to help protect against unauthorized access to Personal Information, such as encryption. But please be aware that no data transmission over the Internet or data storage facility can be guaranteed to be perfectly secure. As a result, while we try to protect your Personal Information, we cannot ensure or guarantee the security of any information you transmit to us.
If you have questions or concerns about our Privacy Practices, or would like to report a violation, please contact us by sending an email to firstname.lastname@example.org