Terms of Service

Consent to Email and Electronic Communications

You consent to the use of unsecured email, mobile phone text message, or other electronic methods of communication ("E-messages") between yourself and Formify Health, your treating provider, and any other agents or representatives involved in your service request, for purposes of discussing material relevant to your service or health records. You understand that E-Messages are typically not confidential means of communication and that there is a reasonable chance that a third-party may be able to intercept and see these messages. You have been informed of the risks of transmitting your protected health information by an unsecured means. You acknowledge that E-messages are not to be used in the case of an emergency, and that you should call 911 or proceed directly to the nearest emergency room.

Consent to Use of Telehealth

You acknowledge you have read, understand and agree to the information below, which applies if you have requested telehealth services for a resident, and that the resident's name and identity have been correctly identified in communications with the medical professional.

You hereby consent to the resident receiving assessment through telehealth from the medical professional as part of the 602a form evaluation. You further give the medical professional permission to consult with relevant specialists as needed during the course of the assessment, and you further consent to the medical professional forwarding medical information to the resident's primary care provider/provider of record (if not the medical professional) or, upon your request, to any other provider.

You are providing the foregoing consents based on your understanding of the following:

• During a telehealth assessment, the medical professional and resident will be in different physical locations and medical information will be communicated electronically.
• The use of telehealth may present certain risks, such as delays due to technological issues, the need to reschedule if transmitted information is of insufficient quality, or failure of potential security protocols which could cause disclosure of personal information.
• A lack of access to complete medical records could result in unintended issues; it is your responsibility to share complete and accurate information.
• The medical professional's information (name, degree, specialty, license, etc.) is available upon request. In the event of an inability to communicate due to technological failure, you may contact Fast 602 support for assistance.
• The medical professional has the sole responsibility and discretion to determine whether telehealth is appropriate for the assessment.
• You have the right to withdraw consent to the use of telehealth at any time without affecting the resident's right to future care or treatment.
• Information disclosed during telehealth will be integrated into the resident's record and generally protected and confidential. Fast 602 uses secure technology compliant with federal privacy laws, incorporating reasonable and appropriate network and software security protocols (including multi-factor authentication and AES256 encryption). However, there is a risk that data security protocols could fail or be breached.
• Fast 602 will not provide personally-identifiable information to any third parties without express consent, except for scheduling, billing, and other treatment, payment, and health care operations purposes, or other uses/disclosures permitted or required by law.
• Fast 602 and its facilitated medical professionals are not responsible for any information lost as a result of technical failures during telehealth.
• If a medical emergency is experienced, you will be directed to call 911; Fast 602 is not able to connect directly to local emergency services.

You have discussed the foregoing information with your facility team and all of your questions have been answered to your satisfaction.

Consent to Healthcare Marketing Communications

You consent to the receipt of communications about other healthcare products or services offered by Fast 602 or its partners and affiliates. These communications may be received in several formats including electronic, SMS, and postal mail.

Consent to Disclosure of Information for Marketing

Fast 602 may share certain protected health information with partners and affiliates that provide, arrange, or offer other healthcare-related services. These partners and affiliates may also receive your information to offer other products and services which may be beneficial to you. By proceeding with your selected services, you are agreeing to have your information shared for internal marketing purposes by Fast 602, as well as external marketing purposes with companies and affiliates with whom Fast 602 works. These communications may be received in either electronic format or postal mail. Please note that you may revoke this consent at any time.

RCFE Acknowledgment

You acknowledge that you (1) have read, understand and accept these Terms of Service; (2) have received a copy of Fast 602's Privacy Policy and further acknowledge that it is available upon request; (3) consent to the use of E-messages between your facility and Fast 602, the facilitated medical professionals, and/or other agents or representatives, for purposes of discussing material relevant to your service requests or resident records; and (4) have read and understand the information contained in the Consent to Use of Telehealth above, and are providing the consents expressly set forth therein.

If an RCFE administrator is unable to consent, you acknowledge that you agree to the terms and conditions of this agreement as the legally authorized representative of the facility.

Service Terms

By using Fast 602's services, you agree to the following terms and conditions:

• You will provide accurate and complete information when using our services.
• You understand that Fast 602 facilitates connections between facilities and medical professionals but does not provide direct medical services.
• You agree to comply with all applicable laws and regulations in your use of our services.
• You acknowledge that our services are subject to availability and may be modified or discontinued at any time.
• You agree to pay all applicable fees for services rendered in accordance with our pricing structure.

Limitation of Liability

To the fullest extent permitted by law, Formify Health shall not be liable for any indirect, incidental, special, consequential, or punitive damages, or any loss of profits or revenues, whether incurred directly or indirectly, or any loss of data, use, goodwill, or other intangible losses, resulting from your use of our services.

Contact Information

If you have any questions about these Terms of Service, please contact us at:

Updates to Terms

We may update these Terms of Service from time to time. We will notify you of any changes by posting the new Terms of Service on this page. You are advised to review these Terms of Service periodically for any changes. Changes to these Terms of Service are effective when they are posted on this page.