NOTICE OF TERMS AND CONDITIONS AND PRIVACY POLICIES; INFORMED CONSENT FOR TELEHEALTH SERVICES
Notice of Terms and Conditions
OUR SERVICES SHOULD NOT BE USED FOR EMERGENCIES. IF YOU THINK YOU HAVE A MEDICAL OR MENTAL HEALTH EMERGENCY, PLEASE CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM.
Amaze PBC (a Delaware public benefit corporation) (“Amaze”, “we”, “us”, or “our”) operates a website located at www.amazehealth.com and a mobile application with links to these Terms and Conditions (collectively, the “Site”). Through the Site, we offer healthcare empowerment training, education and support services through integrated technology solutions and applications (collectively “Services”) to eligible individuals and their immediate family members (“Registered Users”). To avoid any confusion, “immediate family members” means spouse or domestic partner; and child (up to the age of 26). The Site enables Registered Users to engage healthcare practitioners (“Healthcare Practitioners”) to obtain telehealth services (“Healthcare Services”). The Site also has public portions that allow anyone (“Visitors”) to educate themselves on the available Services. Registered Users and Visitors are collectively referred to as “you” or “user.” By accessing and using the Site, you agree to be bound by these Terms and Conditions, and any other terms, conditions and policies that appear on the Site. If you do not wish to be bound by these Terms and Conditions, please do not access or use the Site. We have the right to change these Terms and Conditions at any time. By accessing or using the Site, Services or Healthcare Services after the effective date of any such changes will indicate your acknowledgement of such changes and agreement to be bound by the revised Terms and Conditions. You may always view the most current up-to-date Terms and Conditions at https://amazehealth.com/legal/notices/.
2. Healthcare Services.
The Healthcare Practitioners who deliver Healthcare Services are independent practitioners engaged by the professional practice of Amaze Professional Medical Services LLC (a Colorado limited liability company) (“Amaze Medical”). Amaze does not practice medicine and does not interfere with the practice of medicine by Amaze Medical. Each Healthcare Practitioner is responsible for his or her services and compliance with the requirements applicable to his or her profession and license.
All Health Practitioners on the Site hold professional licenses issued by the professional licensing boards in the states where they practice.
The Healthcare Services are not a replacement for your primary care physician or annual office check-ups, nor are they a replacement for other treating providers. While
consultations treat the majority of common medical and behavioral health conditions, some cases require an in-person visit for complete care.
Amaze Medical is not an online pharmacy, nor are we a Medicare prescription drug plan. Amaze Medical is not a Qualified Health Plan. Amaze Medical is not insurance and is not intended to replace health insurance. The offering of Healthcare Services by Amaze Medical is not to be construed as the sale of insurance product(s) or otherwise engaging in the transaction of insurance.
Disclaimer: None of the Site content (other than information you receive from Healthcare Practitioners) should be considered medical advice or an endorsement, representation or warranty that any particular medication or treatment is safe, appropriate, or effective for you.
3. Privacy and Security.
4. Registered User Accounts.
When you register on the Site, you are required to create an account (“Account”) by entering your name, email address or mobile number, password and certain other information (collectively “Account Information”). To create an Account, you must be at least 18 years of age. If you are not 18 years of age, you may not register to use our Services or Healthcare Services unless a parent or legal guardian has given documented consent. You agree that the Account Information that you provide to us, including during registration and any other 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 (except for sub-accounts 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. We reserve the right to take any and all action, as we deem necessary or reasonable, regarding the security of the Site and your Account Information. In no event and under no circumstances shall we 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.
5. Registered User Responsibilities.
You are responsible for maintaining the confidentiality of your Account password and for all activities that occur under your Account. Specifically, you are responsible for (i) controlling the dissemination and use of activation codes and passwords; (ii) authorizing, monitoring, and controlling access to and use of your username and password; and (iii) promptly informing us of any need to deactivate a password. You also agree to promptly notify us of any unauthorized use of your username, password or any other breach of security that you become aware of involving or relating to the Site by emailing [email protected]. We explicitly disclaim liability for any and all losses and damages arising from your failure to comply with this section.
6. Access and Use Rights and Prohibited Uses.
We hereby grant to you a limited, non-exclusive, nontransferable right to access the Site and use the Services and Healthcare Services solely for your personal use and only as permitted under these Terms and Conditions and any other separate agreements you may have entered into with us (“Access Rights”). We reserve the right, in our sole discretion, to deny or suspend use of the Site, Services or Healthcare Services to anyone for any reason. You agree that you will not, and will not attempt to: (a) impersonate any person or entity, or otherwise misrepresent your affiliation with a person or entity; (b) use the Site, Services or Healthcare Services to violate any applicable law; (c) reverse engineer, disassemble, decompile, or translate any software or other components of the Site; (d) send, transmit, post, or store infringing, obscene, threatening, libelous, defamatory, fraudulent, false, or otherwise unlawful or tortious material, including material harmful to children or violative of third-party privacy rights or the ownership or intellectual property rights of another person; (e) send, transmit, or store material containing software viruses, worms, Trojan horses, or other harmful computer codes, files, scripts, agents, or programs; (f) interfere with or disrupt the integrity or performance of the Site or the data contained therein; (g) attempt to gain unauthorized access to the Site or its related systems or networks; or (h) otherwise use the Services or Site in any manner that exceeds the scope of use granted above. We strongly recommend that you do not use the Services or Healthcare Services on public computers. We also recommend that you do not store your Account password through your web browser or other software.
7. Use of the Site, Services and Healthcare Services by Children.
The Site, Services and Healthcare Services are available for use by children, who are at least 13 years old but under the age of 18 (“Minor”), accompanied by a parent or legal guardian, who gives documented consent. The Registered User for a Minor must be the Minor’s parent or legal guardian. If you register as the parent or legal guardian on behalf of a Minor, you will be fully responsible for complying with these Terms and Conditions and binding the Minor to these Terms and Conditions.
8. Ownership and Intellectual Property Rights.
The Site and its entire contents (except for your personal and health information), features and functionality (including but not limited to all information, software, text, displays, images, video and audio, and the design, selection and arrangement thereof), are owned by us, its licensors or other providers of such material and are protected by copyright, trademark, patent, trade secret and other intellectual property or proprietary rights laws. These Terms
and Conditions permit you to use the Site for your personal use only. You must not reproduce, distribute, modify, create derivative works of, publicly display, publicly perform, republish, download, store or transmit any of the material on our Site except as generally and ordinarily permitted through the Site according to these Terms and Conditions.
9. External Website Links.
The Site may contain links to third-party websites. Linked sites are not under our control, and we are not responsible for the content of any linked site. Links are provided as a convenience only, and a link does not imply that we are affiliated with the linked site. Your use of third-party web sites is at your own risk and subject to the terms and conditions of use for such sites. We disclaim any and all liability for any medical and health treatment information set forth on linked sites.
You may deactivate your Account and end your registration at any time, for any reason by sending an email to [email protected]. We may suspend or terminate your use of the Site, your Account and/or registration for any reason at any time. Subject to applicable law, we reserve 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, we will have no further obligation to provide the Services or Healthcare Services, except to the extent we are obligated to provide you access to your health records or Healthcare Practitioners are required to provide you with continuing care under their applicable legal, ethical and professional obligations to you.
11. Disclaimer of Warranties and Limitation of Liability.
YOU EXPRESSLY AGREE THAT USE OF THE SITE, SERVICES OR HEALTHCARE SERVICES IS AT YOUR SOLE RISK. THE SITE, SERVICES AND HEALTHCARE SERVICES ARE PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS. WE EXPRESSLY DISCLAIM 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, VALUE, ACCURACY OF DATA AND SYSTEM INTEGRATION.
YOU UNDERSTAND THAT TO THE EXTENT PERMITTED UNDER APPLICABLE LAW, IN NO EVENT WILL WE OR ANY OF OUR 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, USE, DATA OR OTHER INTANGIBLE LOSSES ARISING OUT OF OR RELATED TO YOUR USE OF THE SITE, SERVICES OR HEALTHCARE 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.
These Terms and Conditions and your use of the Site shall be governed by the laws of the State of Delaware, without giving effect to the principles of conflict of laws. Any dispute, claim, cause of action, or legal suit arising out of or related to these Terms and Conditions shall be instituted exclusively in the federal courts of the United States or the courts of the State of Colorado, in each case located in the city and county of Denver. You waive any and all objections to the exercise of jurisdiction over you by such courts and to venue in such courts.
No waiver by us of any provision set forth herein shall be deemed a further or continuing waiver, or a waiver of any other provision, and any failure of us to assert a right under these Terms and Conditions shall not constitute a waiver of such right. If any provision of these Terms and Conditions is illegal or unenforceable under applicable law, the remainder of the provision will be amended to achieve as closely as possible the effect of the original term, and all other provisions of these Terms and Conditions will continue in full force and effect.
Notice of Health Information Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This section, “Notice of Health Information Privacy Practices” or “Notice”, contains important information regarding your health information. The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) imposes numerous requirements on how certain individually identifiable health information – known as protected health information or (“PHI”) – may be used and disclosed. This Notice describes how the Healthcare Practitioners who deliver Healthcare Services and who are independent practitioners engaged by the professional practice of Amaze Professional Medical Services LLC (a Colorado limited liability company) (“Amaze Medical”, “we”, “us”, or “our”) (and how Amaze PBC (a Delaware public benefit corporation) (“Amaze”) when acting on behalf of Amaze Medical) may use and disclose your health information and how you can access this information. Please review it carefully.
1. Our Commitment to Privacy.
We understand that health information about you and your health is personal. We are committed to protecting health information about you and will use it to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request of it. We continuously seek to safeguard that information through administrative, physical and technical means, and otherwise abide by applicable federal and state guidelines.
2. Our 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.
Our current Notice is posted at https://amazehealth.com/legal/notices/. We reserve the right to change the terms of this Notice at any time. If we do, the new terms will be effective for all of the health information we already have about you as well as any information we receive in the future. If you received this Notice electronically, you are entitled to a paper copy of this Notice upon request. If you have any questions about this Notice please contact the person listed below.
3. Our Use and Disclosure of Your Health Information.
HIPAA generally permits use and disclosure of your health information without your permission for purposes of health care treatment, payment activities, and health care operations. These uses and disclosures are more fully described below. Please note that this Notice does not list every use or disclosure; instead it gives examples of the most common uses and disclosures.
• Treatment: When and as appropriate, we may use or disclose health information about you to facilitate medical treatment or services by healthcare providers, including doctors, nurses, technicians, or other personnel who are involved in taking care of you.
• Payment: When and as appropriate, we may use and disclose health information about you to determine your eligibility for the Health Plans’ benefits, to facilitate payment for the treatment and services you receive from health care providers, to determine benefit responsibility and coverage under the Health Plans, or to coordinate your coverage.
• Health Care Operations: When and as appropriate, we may use and disclose health information about you for operations, as needed. For example, we may use medical information in connection with: conducting quality assessment and administration improvement; conducting or arranging for medical review, legal services; business planning and development such as cost management; and business management and general administrative activities.
4. Other Permitted Uses and Disclosures of Your Health Information.
• Disclosure to Others Involved in Your Care: We may disclose health information about you to a relative, a friend, or to any other person you identify, provided the information is directly relevant to that person’s involvement with your health care or payment for that care.
• Comply with Federal and State Requirements: We will disclose health information about you when required to do so by federal, state, or local law.
• Workers’ Compensation: We may release health information about you for workers’ compensation or similar programs.
• To Avert a Serious Threat to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
• Military and Veterans: If you are a member of the armed forces, we may release health information about you as required by military command authorities.
• Business Associates: We may disclose your health information to third parties with whom we do business (defined as “Business Associates” under HIPAA). We will enter into contracts with these entities requiring them to only use and disclose your health information as we are permitted to do so under HIPAA.
• Public Health Activities: We may disclose your health information to public health authorities or other governmental authorities for purposes including preventing and controlling disease, reporting child abuse or neglect, reporting domestic violence and reporting to the Food and Drug Administration regarding the quality, safety and effectiveness of a regulated product or activity.
• Health Oversight Activities: We may disclose your health information to a health oversight agency for authorized activities such as audits, investigations, inspections, licensing and disciplinary actions relating to the healthcare system or government benefit programs.
• Judicial and Administrative Proceedings: We may disclose your health information, in certain circumstances, as permitted by applicable law, in response to an order from a court or administrative agency, or in response to a subpoena or discovery request.
• Decedents: We may, under certain circumstances, disclose your health information to coroners, medical examiners and funeral directors for them to fulfill their duties.
• Research: We may, under certain circumstances, use or disclose your health information that is necessary for research purposes.
• Other Uses: We may use and disclose medical information about you to tell you about health-related products and services; communicate within our organization for treatment, payment, or healthcare operations; or facilitate organ or tissue donation and transplantation.
Uses and disclosures other than those described in this Notice will require your consent and/or authorization. You may revoke your consent and/or authorization at any time, but you cannot revoke your authorization if we have already acted on it.
5. Your Rights Regarding Your Health Information.
You have the following rights regarding health information that we maintain about you:
• Right to Inspect and Copy: You have the right 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.
• Right to Amend: You have the right to 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.
• Right to an Accounting of Disclosures: You have the right to 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.
• Right to Request Restrictions: You have the right to 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.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
6. Breach Notification.
You have the right to be notified in the event that we discover a breach of unsecured health information. Such notification shall be consistent and in accordance with the Health Information Technology for Economic and Clinical Health Act of 2009 and its implementing regulations (collectively, “the HITECH Act”) under the American Recovery and Reinvestment Act of 2009 (“ARRA”).
7. Complaint and Contact Information.
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. 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. 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:
Email: [email protected]
Address: Attn: Privacy and Security Officer, 555 17th Street, Suite 400, Denver, CO 80202
3. Collection of Personal and Health Information.
• 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 Practitioners who provide clinical services through the Site such as medical records, treatment and examination notes, and other health related information.
4. Use and Disclosure of Personal and Health Information.
• We may use personal and health information:
1. To provide you with the Services or Healthcare Services.
2. To improve the Services or Healthcare Services through the performance of quality reviews and similar activities.
3. To create non-identifiable Information such as aggregate statistics relating to the use of the Services or Healthcare Services.
4. To fulfill any other purpose for which you provide us Personal and Health Information.
5. For any other purpose for which you give us consent and/or authorization.
• We may disclose personal and health information:
1. 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.
2. As required by law.
3. For any other purpose disclosed by us when you provide the information.
As portions of the Site can only be accessed and used by Registered Users, we must be able to link a Registered User’s activity back to their identity, for example, to verify identity in our systems and eligibility for the Services or Healthcare Services. Therefore, we do collect identifiable, personal and health information about Registered Users.
While no Site can guarantee perfect security, we maintain physical, administrative, and technical safeguards to help protect personal and health information as required by applicable law. While we cannot guarantee that loss, misuse or alteration to data will not occur, we use industry standards, such as Secure Socket Layers (“SSL”) technology, to
help safeguard against such occurrences. The information passed between your browser and our system is encrypted with SSL technology to create a protected connection between you and our Site to ensure confidentiality.
Our servers are protected behind the Internet by using firewall and encryption technology. All data is stored and transferred in encrypted formats that either meet or exceed standards defined by applicable federal and state laws. No data is transferred to users that do not have rights to access such information.
6. Mobile Applications.
We allow Registered Users to access the Site, Services or Healthcare Services through a software application on a mobile device (an “Application”). If you choose to use the Application, we will collect additional information about you including (1) location data, (2) device IDs and (3) other information regarding your use of the Application. We use the information collected to analyze and improve the Registered User’s experience using the Application and otherwise communicate with the Registered User. Additionally, we track your location and send push notifications from time-to-time in order to update you about the Services or Healthcare Services and what is available to you as a Registered User. If you no longer wish to receive such communications, you may turn them off at the device level.
7. Collection, Use and Disclosure of Non-Identifiable Information.
We, or a third-party vendor on our behalf, may collect non-identifiable information, which is automatically collected as you browse or otherwise access the Site. We may collect such information by tracking, or asking a third-party vendor to track, your click-stream activity when such information is not tied to your identification through the use of “cookie” technology or by tracking internet protocol (IP) addresses, as explained below.
Because we want our Site to better serve Visitors’ needs, we collect some basic information about Visitors’ computers, including, but not limited to:
• IP address (the computer’s address on the internet)
• Operating system (e.g. Windows 10)
• Browser software (e.g. Google Chrome, Mozilla Firefox, Microsoft Internet Explorer)
• Internet Service Provider (e.g. Comcast, CenturyLink)
• Geographic location (e.g. Denver, CO)
We use this information to continuously enhance our Site and to better serve our Visitors’ needs. For example, we use this information to know what browsers people most commonly use, what pages are most often visited, and what functionality is most used. All the information we collect from Visitors’ computers is de-identified and is not personal information.
The non-identifiable information we collect may be shared with our suppliers and vendors and used in the aggregate to create summary statistics that help us analyze Site usage trends, assess what information is of most and least importance, determine technical design specifications, arrange the Sites in the most user-friendly way, and identify system performance or problems.
8. Cookies Policy.
When you use or access the Site, we may place cookies in your web browser. Cookies are small pieces of text sent by your web browser by a website you visit. Cookies can be “persistent” or “session” cookies. We use both types of cookies for purposes such as: to enable certain functions; to provide analytics; and to store your preferences. We may also use essential cookies to authenticate users and prevent fraudulent use of user accounts.
10. Contact Information.
Email: [email protected]
Address: Attn: Privacy and Security Officer, 555 17th Street, Suite 400, Denver, CO 80202
Informed Consent for Telehealth Services
Telehealth involves Healthcare Practitioners delivering Healthcare Services to patients via interactive video communications, audio communications, and/or by the electronic
transmission of information. In other words, telehealth involves the use of electronic communications to enable Healthcare Practitioners at different locations to (i) evaluate, diagnose, manage, and/or treat health problems and (ii) share individual patient medical information for the purpose of improving patient care. The information may be used for diagnosis, therapy, follow-up and/or education, and may include any of the following:
• Patient medical records
• Medical images
• Live two-way audio and video (which may be recorded for quality and training purposes)
• Output data from medical devices and sound and video files
Electronic systems used will incorporate network and software security protocols to protect the confidentiality of patient identification and imaging data and will include measures to safeguard the data and to ensure its integrity against intentional or unintentional corruption.
2. Expected Benefits.
• Improved access to medical care by enabling a patient to remain in his/her local health care site (e.g., home or work) while the health care provider consults and/or obtains test results at distant/other sites
• More efficient medical evaluation and management
• Obtaining the expertise of a specialist
3. Possible Risks.
As with any medical procedure, there are potential risks associated with the use of telehealth. These risks include, but may not be limited to:
• In rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate medical decision making by the Healthcare Practitioner
• Delays in medical evaluation and treatment could occur due to deficiencies or failures of the equipment
• In very rare instances, security protocols could fail, causing a breach of privacy of personal medical information
• In rare cases, a lack of access to complete medical records may result in adverse drug interactions or allergic reactions or other judgment errors
By signing this Informed Consent, you understand the following:
1. You understand that the laws that protect privacy and the confidentiality of medical information also apply to telehealth, and that no information obtained in the use of telehealth which identifies you will be disclosed without your consent.
2. You understand that you have the right to withhold or withdraw your consent to the use of telehealth in the course of your care at any time, without affecting your right to future care or treatment.
3. You understand that you have the right to inspect all information obtained and recorded in the course of a telehealth interaction, and may receive copies of this information.
4. You understand that a variety of alternative methods of medical care may be available to you, and that you may choose one or more of these at any time. You understand that not all patient situations will be appropriate for telehealth. Your Healthcare Practitioner has explained the alternatives to your satisfaction.
5. You understand that telehealth may involve electronic communication of your personal medical information to other medical practitioners who may be located in other areas, including out of state.
6. You understand that you may expect the anticipated benefits from the use of telehealth in your care, but that no results can be guaranteed or assured.
You have read this Informed Consent (including, but not limited to, the risks and benefits associated with teleconferencing by video, audio, or other electronic means) and you understand it. You hereby give your informed consent to participate in a telehealth visit under the terms described herein.
Effective Date: January 18, 2022