E-SIGN DISCLOSURE AND CONSENT
This Electronic Disclosure and Consent (“Disclosure”) applies to any privacy or other notices, disclosures, reports, documents, communications, or other records provided to you by Continuwell (“CW”) (collectively, “Notices”). Specifically, by agreeing to these Terms, you agree that (i) CW may provide you with its “Notice of Privacy Practices”, “Consent to Use and Disclose Protected Health Information for Treatment, Payment and Healthcare Operations” and all other Notices in electronic form and (ii) CW may obtain from you your electronic signature, which will serve as your legal signature.
All Notices that Continuwell elects to provide to you in electronic form will be provided either (i) via e-mail to the address that you provide or (ii) by posting the Notice on the website. The delivery of any Notice is effective when sent, regardless of how it is delivered to you, whether you read the Notice when you receive it, or whether you actually receive the delivery. You must promptly notify us of any change in your email or other electronic address by sending us an email to email@example.com or calling us at 844-258-4325.
If at any time you decide to withdraw your consent, you may do so by emailing at firstname.lastname@example.org or calling us at 844-258-4325. Withdrawal of your consent will not be valid to the extent that CW has already relied upon it and any withdrawal of your consent to receive Notices in electronic form will be effective only after we have a reasonable period of time to process your withdrawal. CW will not impose any fee to process the withdrawal of your consent.
In order to access, view, and retain the Notices, you must have: (i) access to a personal computer, operating system, and telecommunications connections to the Internet capable of receiving, accessing, displaying, and either printing or storing Notices in electronic form via a plain text-formatted e-mail or by access to the website using a current Internet browser application (e.g., Internet Explorer, Firefox, Safari), (ii) an e-mail account (and any necessary e-mail software), and (iii) a current version of a program that accurately reads and displays PDF files (such as Adobe Acrobat Reader).
CW will not send you a paper copy of a Notice which is available electronically unless you request it, or we otherwise deem it appropriate to do so. You can obtain a paper copy of a Notice by printing it or by requesting that we mail you a paper copy. To request a paper copy, call us at 844-258-4325. CW may charge you a reasonable service charge, of which we will have provided you prior notice, for the delivery of paper copies of any Notice provided electronically pursuant to this authorization. CW reserves the right, but assumes no obligation, to require you to receive and sign a paper (instead of electronic) Notice.
All Notices delivered to you in either electronic or paper format will be considered “in writing.” You should print or download for your records a copy of this Disclosure and your Notices.
CW reserves the right, in its sole discretion, to discontinue permitting electronic Notices, or to terminate or change the terms and conditions on which it delivers electronic Notices. CW will provide you with notice of any such termination or change as required by law.