Results Sharing Authorization
I hereby authorize that I am electronically sending the laboratory test results performed on me (the “Results) by TBD HEALTH INC. (the “Company”) via the Company’s results sharing website feature (the “Share Feature”) either via text message or email form. I understand and acknowledge that all results shall be abstracted as is indicated on the applicable Share Feature screen and may or may be considered "protected health information" under the Health Insurance Portability and Accountability Act (“HIPAA”).
I understand that upon submitting this Results Sharing Authorization (this “Authorization”) that all of the inserted recipients may have access to my Results for a certain period of time.
I understand that the Company explicitly disclaims liability for any and all losses and damages in accordance with the Terms of Service, which shall include but not be limited to the incorrect entry of data, such as recipient name, email and/or phone, or if a technological or any other malfunction shall occur.
I also understand that the recipients with whom I share my Results may further share, distribute or otherwise disclose such Results with additional third parties and such Results may no longer be protected by the privacy and security regulations of HIPAA.
I understand that this Authorization will remain in effect for all subsequent testing, as the case may be, that I may receive at the Company, and such Authorization shall expire when I revoke access to such Results or when I otherwise notify the Company in writing by emailing email@example.com.