STRIVEIV TERMS OF USE:

IMPORTANT INFORMATION

You should carefully read the following Terms of Use Agreement (“Agreement”). Your use of our Website, InteractiveMobile Application, and/or our service(s) implies that you have read and accepted these terms and conditions. The Website and Interactive Mobile Application (all of StriveIV™ websites, interactive mobile application may hereafter be referred to, both individually and collectively, as the “Service”) from which you accessed this Agreement is provided to you subject to the conditions listed below. These terms are in addition to any other terms that individual Service owners, which are within StriveIV™ family, may include for governing access to the respective Service.

The access rights granted to you under this Agreement are non-transferable without the express written permission of the owners of StriveIV™. You are responsible for the actions of any other person who may utilize your access rights or account on the Service.

INTRODUCTION

The following terms and conditions govern all use of the StriveIV™ Service, all content, services and products available at or through the Website or interactive mobile application. The Service is offered subject to your acceptance without modification of all of the terms and conditions contained herein and all other associated operating rules and policies (including, without limitation, StriveIV™ Notice of Privacy Practices, which can be found here: https://www.striveiv.com/terms-of-service/

Please read this Agreement carefully before accessing or using the Service. By accessing or using any part of the Service, you agree to become bound by the terms and conditions of this Agreement. If you do not agree to all the terms and conditions of this Agreement, then you must leave the Service and you may not use any services of StriveIV™. You have the right to refuse Service by stopping all usage of Service. If these terms and conditions are considered an offer by StriveIV™, acceptance is expressly limited to these terms.

The Service is designed to enable you (an adult who is at least 21 years of age) to request intravenous hydration services provided by a licensed medical professional. Your IP address or the GPS receiver (from your mobile device) assists in detecting your location. You have the ability to select your location as well. The Application identifies you to the healthcare professional, who will perform healthcare services for you. After your selection, the Service then sends a message to the professional in your requested city that asks the professional whether he or she would like to provide you with the requested healthcare service. In the event a health care professional agrees to provide you with healthcare service, the Service schedules the medical service and bills you on behalf of the healthcare professional. We make no representation or warranty to you any health care professional will be available to perform health care service.

STRIVEIV IS NOT ENGAGED IN THE PRACTICE OF MEDICINE, DOES NOT PROVIDE MEDICAL SERVICES, AND IS NOT A HEALTH CARE PROVIDER. THE HEALTH CARE PROFESSIONAL WITH WHICH YOU ESTABLISH A TREATMENT RELATIONSHIP IS SOLELY RESPONSIBLE FOR PROVIDING YOU WITH MEDICAL SERVICE. NOTE ALL REFERENCES TO MEDICAL SERVICE DOES NOT INCLUDE STRIVEIV™ SERVICE. WE ONLY ACT AS A TECHNOLOGY PLATFORM TO CONNECT YOU WITH HEALTH CARE PROFESSIONALS WHO MAY BE INTERESTED IN PROVIDING YOU WITH A MEDICAL SERVICE.

THE SERVICE IS AVAILABLE ONLY TO INDIVIDUALS WHO ARE AT LEAST 21 YEARS OLD, OR 18 YEARS OLD WITH THE CONSENT AND PRESENCE OF A PARENT. IF YOU ARE NOT YET 21 YEARS OLD, OR 18 WITHOUT A PARENT PRESENT, YOU MUST STOP USING THE SERVICE IMMEDIATELY. FURTHER, YOU AGREE THAT YOU HAVE THE CAPACITY AND UNDERSTANDING TO AGREE TO THE TERMS HEREIN.

SPECIAL LICENSE RESTRICTIONS FOR NON-HUMAN VISITORS

Any Non-Human Visitors (as defined below) to the Service shall be considered agents of the individual(s) who controls, authors or otherwise makes use of such Non-Human Visitors. Such individual(s) shall be deemed solely responsible for the actions of their Non-Human Visitors in the same manner as if they personally visited the Service.

A special restriction on a visitor’s license to access the Service applies to all Non-Human Visitors. “Non-Human Visitors” include, but are not limited to, web spiders, bots, indexers, robots, crawlers, harvesters, or any other computer programs designed to access, read, compile or gather content from the Service automatically.

Email addresses on the Service are considered proprietary intellectual property. It is recognized that these email addresses are provided for human visitors alone. Intentional collection, harvesting, gathering, and/or storing of the Service’s email addresses is recognized as a violation of this Agreement and expressly prohibited.

FEES, PAYMENT AND REFUNDS

A service scheduled and/or purchased from StriveIV™, through the Service or otherwise, are provided by licensed medical professionals contracted with StriveIV, LLC.

By scheduling an appointment with StriveIV™, through the Service or otherwise, you agree to pay StriveIV™ the fee indicated for the service that has been scheduled. Payments will be charged at the time of scheduling. STRIVEIV™ REQUIRES AT LEAST 24 HOUR ADVANCED NOTICE OF CANCELLATION. You will be charged the full amount of the fee indicated for the service(s) scheduled if you cancel an appointment within 24 hours of its scheduled time. However, you may cancel an appointment without charge if it is cancelled within ten (10) minutes of being scheduled through the Service or otherwise. MISSED APPOINTMENTS ARE NOT REFUNDABLE. In the unusual event we are unable to provide our service to you because of our availability, a CREDIT or a REFUND WILL BE PROVIDED. Credits or refunds will not be provided to customers who are unsatisfied with the medical service.

In the event that the medical professional engaged by StriveIV™ is unable to perform the portion of the scheduled service(s) that follows the insertion of the I.V. needle due to circumstances out of the medical professional’s control (e.g. the I.V. drip will not begin after the medical professional has made an attempt), you will receive a credit or refund of the full amount of the medical service scheduled.

In the event that you misrepresent yourself in any way, including, but not limited to, your age, name, or the medical history provided by you is not accurate (as determined by a medical professional engaged by StriveIV™) at the time of the appointment, or you are under the influence of drugs or alcohol at the time of the appointment, you will be charged for the full amount of the service scheduled but no service will be provided.

Upon your acceptance of these terms and submission of your purchase, you hereby agree that StriveIV™ has the right to automatically charge your credit card (or other payment method) for the applicable fees or charges, plus any applicable taxes that StriveIV™ is required to collect, and you authorize StriveIV™ to do so. StriveIV™ is not liable for any losses of any kind associated with collecting or processing payments.

If you make a payment by credit card, your credit card information will be stored on www.authorize.net and will only be accessed by authorized agents on behalf of StriveIV™ for the purpose of obtaining payment. In the event that you elect to change the service scheduled and/or purchased from StriveIV™ prior to the delivery of such service, StriveIV™ may, in StriveIV™’s sole discretion, use your stored credit card information to charge you for the additional service provided or to provide a credit to you for the service that was not provided, as the case may be, and you authorize StriveIV™ to do so. In the case of an applicable credit, such credit will be given to you approximately two (2) to three (3) business days after you have notified StriveIV™ of the respective change in the service that was to be provided, subject to the policies of the respective credit card companies. You acknowledge that it is your responsibility to ensure that payment in advance for the service scheduled and/or purchased from StriveIV™, and to ensure that your credit cards or other payment instruments accepted by StriveIV™ continue to be valid and sufficient for such purposes.

GIFT CERTIFICATES

Gift certificates are only good for a single transaction; any remaining amount is not exchangeable with cash or another voucher and will be automatically forfeited. Any additional cost exceeding the value of this voucher will be paid by the redeemer. Gift certificates will be considered null and void without the Expiry Date and Authorized Signature being filled up, seal and other authentication signs or if tampered. Gift certificates will not be replaced when lost, damaged or stolen. If purchased from a seller other than www.striveiv.com, then gift certificates validation is required by the reseller affiliate. A gift certificate entitles the bearer to redeem the product specified herein. Gift certificates are valid only at www.striveiv.com. StriveIV™ reserves the right to amend, revise or revoke these terms and conditions without prior notice.

GENERAL DISCLAIMER

THE SERVICE PROVIDES INFORMATION ABOUT HEALTH ISSUES DESIGNED TO HELP USERS MAKE BETTER DECISIONS, BUT MEDICAL INFORMATION IS NOT THE SAME AS MEDICAL ADVICE. YOU, AS THE USER OF THE SERVICE, ASSUME FULL RISK AND RESPONSIBILITY FOR ANY AND ALL USE OF THE SERVICE, INCLUDING THE INFORMATION PRESENTED THEREON. THE SERVICE IS INTENDED TO BE A GENERAL INFORMATION RESOURCE ONLY AND DOES NOT CONSTITUTE MEDICAL ADVICE AND IS NOT A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE OR TREATMENT. YOU ARE RESPONSIBLE FOR SEEKING PROFESSIONAL MEDICAL ADVICE IF YOU HAVE ANY QUESTIONS ABOUT YOUR HEALTH OR A HEALTH CONDITION. YOU AGREE TO HOLD STRIVEIV™ AND ITS AFFILIATES HARMLESS FROM ANY AND ALL CLAIMS, DAMAGES, CAUSES OF ACTION, JUDGMENTS, LIABILITIES, EXPENSES AND DEMANDS OF ANY KIND OR NATURE WHATSOEVER RELATING TO YOUR USE OF, YOUR RELIANCE UPON, OR ERRORS OR OMISSIONS IN, INFORMATION FOUND ON THE SERVICE.

YOU USE THE SERVICE OF STRIVEIV™ AT YOUR OWN RISK. STRIVEIV™ WILL NOT BE LIABLE TO YOU OR ANYONE ELSE FOR ANY HARM TO YOU OR OTHERS RESULTING FROM THE USE, DISCLOSURE OR RETAINED INFORMATION OF THE SERVICE AND/OR THE MEDICAL TREATMENTS AND PRODUCTS PROVIDED THROUGH THE SERVICE OR OTHERWISE. STRIVEIV™ DOES NOT MAKE ANY CLAIMS, REPRESENTATIONS OR WARRANTIES REGARDING YOUR FITNESS FOLLOWING RECEIPT OF SERVICE FROM STRIVEIV™, INCLUDING, BUT NOT LIMITED TO, WHETHER YOU ARE FIT TO DRIVE A VEHICLE OR OPERATE MACHINERY AFTER YOU RECEIVE SERVICE FROM STRIVEIV™. FURTHER, YOU MAY NEED SOMEONE TO ACCOMPANY YOU AFTER RECEIVING THE SERVICE UNTIL YOU FEEL, IN YOUR SOLE OPINION, ABLE TO RESUME NORMAL ACTIVITIES.

StriveIV™ does not condone, recommend, or encourage excess alcohol consumption. Excessive drinking is highly detrimental to one’s health and wellness, and may lead to a number of irreversible diseases, including, but not limited to, alcoholism, cirrhosis of the liver, and cancer. Please drink responsibly. While there may be information on the Service related to certain medical conditions and their management, should a medical condition exist, promptly see your own physician or health provider.

RESPONSIBILITY OF SERVICE VISITORS

StriveIV™ disclaims any responsibility for any harm resulting from the use by visitors of the Service, or from any downloading by such visitors of the content on the Service. Any user who finds content that is offensive, indecent, or otherwise objectionable, or content containing technical inaccuracies, typographical mistakes, or other errors has a responsibility to report such content to StriveIV™.

You represent and warrant that (i) your use of the Service will be in strict accordance with the Notice of Privacy Practices, with this Agreement and with all applicable laws and regulations (including without limitation any local laws or regulations in your country, state, city, or other governmental area, regarding online conduct and acceptable content, and including all applicable laws regarding the transmission of technical data exported from the country in which you reside),  (ii) your use of the Service will not infringe or misappropriate the intellectual property rights of any third party, (iii) you are an adult (at least 21 years of age or older), and (iv) your account/information is true and accurate.

COPYRIGHT INFRINGEMENT AND DMCA POLICY

As StriveIV™ asks others to respect its intellectual property rights, it respects the intellectual property rights of others. If you believe that material located on or linked to by the Service violates your copyright, you are encouraged to notify StriveIV™. StriveIV™ will respond to all such notices, including as required or appropriate by removing the infringing material or disabling all links to the infringing material. In the case of a visitor who may infringe or repeatedly infringes the copyrights or other intellectual property rights of StriveIV™ or others, StriveIV™ may, in its discretion, terminate or deny such visitor access to and use of the Service. In the case of such termination or denial, StriveIV™ will have no obligation to provide a refund of any amounts previously paid to StriveIV™ by the visitor whose access/use was terminated or denied. StriveIV™ maintains the right to refuse Service to any visitor with or without notice.

INTELLECTUAL PROPERTY

StriveIV™, the StriveIV™ domain, the StriveIV™ logo, and all other trademarks, service marks, graphics and logos used at any time in connection with StriveIV™, or the Service are trademarks or registered trademarks of StriveIV, Inc. Other trademarks, service marks, graphics and logos used in connection with the Service may be the trademarks of other third parties. Your use of the Service does not grant you any right or license to reproduce or otherwise use any of StriveIV™’s trademarks or third-party trademarks.

SITE MODIFICATIONS

StriveIV™ reserves the right, at its sole discretion, to modify or replace any part of this Agreement at any time without notice. It is your responsibility to check this Agreement periodically for changes. Your continued use of or access to the Service following the posting of any changes to this Agreement constitutes acceptance of those changes. By using this Service you are agreeing to be bound by the then current version of these Terms of Use, including any and all of the revisions. StriveIV™ may also, in the future, offer new features through the Service (including, but not limited to, the release of new tools and resources). Such new features shall be subject to the terms and conditions of this Agreement.

TERMINATION

StriveIV™ may terminate your access to all or any part of the Service at any time, with or without cause, with or without notice, effective immediately. If you wish to terminate this Agreement, you may simply discontinue using the Service. StriveIV™ can terminate the Service immediately as part of a general shut down of our service or other lawful reason. Upon termination, all provisions of this Agreement which by their nature should survive termination shall survive termination, including, without limitation, ownership provisions, intellectual property, warranty disclaimers, indemnity and limitations of liability.

BREACH

You hereby acknowledge that your breach of this Agreement or the Notice of Privacy Practices may result in immediate and irreparable harm to StriveIV™. Accordingly, you hereby agree that, in the event of such a breach by you, StriveIV™ shall be entitled to equitable relief to compel you to cease and desist all unauthorized use, evaluation and/or disclosure of information obtained through the Service, as well as any and all other remedies available at law or in equity.

DISCLAIMER OF WARRANTIES

The service, information, functions and materials on the Service are provided ‘as is’. StriveIV™ makes no warranties, expressed or implied, and hereby disclaims and negates all other warranties, including without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. Further, StriveIV™ does not warrant or make any representations concerning the accuracy, likely results, or reliability of (a) the use of the materials on the Service or otherwise relating to such materials or (b) any sites linked to or on the Service.

LIMITATION OF LIABILITY

In additional to, and not in limitation of, any limitations of liability provided by law or this Agreement, in no event will StriveIV™, or its suppliers or licensors, or any individuals associated with StriveIV™, its suppliers or licensors, including, but not limited to, their respective equity owners, be liable with respect to any subject matter of this Agreement under any contract, negligence, strict liability or other legal or equitable theory for any special, incidental or consequential damages. The foregoing shall not apply to the extent prohibited by applicable law.

INDEMNIFICATION

You agree to indemnify and hold harmless StriveIV™, its contractors, and its licensors, and their respective directors, officers, employees and agents from and against any and all claims, damages, causes of action, judgments, liabilities, demands and expenses of any kind or nature whatsoever, including attorneys’ fees, arising out of your use or your account’s use of the Service, including but not limited to, arising out of your violation of this Agreement.

APPLICABLE LAW AND JURISDICTION

You agree that any suit, action or proceeding between you and StriveIV™ in connection with or arising from this Agreement (each, a “Judicial Action”) shall be governed by the law of the state of residence of the registered Administrative Contact (the “Admin State”) for the Service as such laws are applied to agreements between Admin State residents entered into and performed entirely within the Admin State. You consent to the jurisdiction of federal and state courts within the Admin State. You consent to the venue in any Judicial Action brought against you in connection with breaches of this Agreement. You consent to electronic service of process regarding any Judicial Action under this Agreement.

RECORDS OF VISITOR USE AND ABUSE

You consent to having your Internet Protocol address recorded.

VISITORS AGREE THAT HARVESTING, GATHERING, STORING, REPRODUCING, COPYING, TRANSFERRING TO A THIRD PARTY OR SENDING ANY MESSAGE(S) TO THE IDENTIFIER CONSTITUTES AN ACCEPTANCE AND SUBSEQUENT BREACH OF THIS AGREEMENT. STRIVEIV™ RESERVES THE RIGHT TO MONITOR AND INVESTIGAGE ALL CLAIMS/POTENTIAL VIOLATIONS IN ITS SOLE DETERMINATION AND JUDGEMENT.

PRIVACY POLICY

StriveIV LLC, owns and operates the Website. StriveIV™ is committed to the privacy and security of its visitors’ information. Some of the activities on the Service, such as the scheduling of an appointment, require StriveIV™ to collect personal identifying information from you. All personal information provided by you is held in confidence by StriveIV™ and will not be shared with third parties (excluding appropriate usages to affiliates, subsidiaries, contractors, agents, etc.) for any reason, unless it is necessary to process a request made by you or as otherwise legally required. Further, StriveIV™ may collect data from the Service, such as the pages visited, how much time a visitor spends on the Service, and a visitor’s IP address, in order to improve the content provided on the Website. If you have any questions about our Privacy Policy, please feel free to contact us. If you disagree with this policy, immediately stop all usage of this Service.

The following is StriveIV™’s Notice of Privacy Practices: https://www.striveiv.com/terms-of-service/

SOCIAL MEDIA USAGE AND POLICY

StriveIV™ has opened publicly facing pages on social media sites for viewing content and/or videos and posting comments about StriveIV™. These social media sites include but are not limited to various blogs, bulletin boards, networks, multi-media and news media sites or other user generated content sites (each, a “Social Media Site” and collectively, the “Social Media Sites”). When using social media sites operated by others, you must also follow their rules of conduct and abide by their terms of use. By accessing, viewing and/or posting any content related directly or indirectly to StriveIV™ on any Social Media Site on the internet, you accept, without limitation or qualification, the following terms of use. If you do not agree to these terms, you may not view or post any content related directly or indirectly to StriveIV™ to any Social Media Site on the internet. Your use of Social Media Sites is acceptance of these terms and has the same effect as if you had actually physically signed an agreement.

1.         You must be at least 21 years old to post any content on any Social Media Site.

2.         You are prohibited from posting any content that is personal health information including but not limited to patient images on any Social Media Site. You are also prohibited from using any Social Media Site to provide medical advice or medical commentary by non-physicians or to use the Social Media Site to make, recommend or increase referrals to physicians who are not employed by StriveIV™.

3.         By posting content to any Social Media Site, you agree that you will not: (a) violate any local, state, federal and international laws and regulations, including but not limited to copyright and intellectual property rights laws regarding any content that you send or receive via this Social Media Usage Policy; (b) impersonate any person or entity or falsely state or otherwise misrepresent your affiliation with a person or entity; (c) collect or store, or attempt to collect or store, personal data about third parties without their knowledge and written consent; (d) share confidential pricing information of any party; or (e) share information gained from usage of the Service that would not otherwise be publically known.

4.         By posting content to any Social Media Site, you agree that you will not transmit any material (by uploading, posting, email or otherwise): (a) that is unlawful, disruptive, threatening, profane, abusive, harassing, embarrassing, tortuous, defamatory, obscene, libelous, or is an invasion of another’s privacy, is hateful or racially, ethnically or otherwise objectionable as solely determined in StriveIV™’s discretion; (b) that you do not have a right to make available under any law or under contractual or fiduciary relationships; (c) that infringes any patent, trademark, trade secret, copyright or other proprietary rights of any party; (d) that is unsolicited or unauthorized advertising (including advertising of non StriveIV™ service or products), promotional materials, “junk mail,” “spam,” “chain letters,” “pyramid schemes” or any other form of solicitation; or (e) that contains software viruses, worms, disabling code, or any other computer code, files or programs designed to interrupt, destroy or limit the functionality of any computer software or hardware or telecommunications equipment.

5.         By posting any content on any Social Media Site, you grant to StriveIV™ the irrevocable right to reproduce, distribute, publish, display such content and the right to create derivative works from your content, edit or modify such content and use such content for any StriveIV™ purpose.

6.         StriveIV™ reserves the right to monitor, prohibit, restrict, block, suspend, terminate, delete, or discontinue your access to any Social Media Site, at any time, without notice and for any reason and in its sole discretion. StriveIV™ may remove, delete, block, filter or restrict by any other means any materials in StriveIV™’s sole discretion. You understand and agree that StriveIV™ may disclose your communications and activities with StriveIV™ in response to lawful requests by governmental authorities, including Patriot Act requests, judicial orders, warrants or subpoenas, or for the protection of StriveIV™’s rights. You agree that in the event that StriveIV™ exercises any of its rights hereunder for any reason, StriveIV™ will have no liability to you.

7.         You shall defend, indemnify, and hold StriveIV™ and its corporate affiliates and their respective officers, directors, employees, contractors, agents, successors and assigns harmless from and against, and shall promptly reimburse them for, any and all losses, claims, damages, settlements, costs, and liabilities of any nature whatsoever (including reasonable attorneys’ fees) to which any of them may become subject arising out of, based upon, as a result of, or in any way connected with, your posting of any content to a Social Media Site, any third party claims of infringement or any breach of this Social Media Usage Policy. You agree that any claim or dispute relating to your posting of any content on a Social Media Site on the internet shall be construed in accordance with the laws of the State of Connecticut without regard to its conflict of laws provisions and you agree to be bound and shall be subject to the exclusive jurisdiction of the local, state or federal courts.

8.         You expressly acknowledge that you assume all responsibility related to the security, privacy, and confidentiality risks inherent in sending any content over the internet. By its very nature, a website and the internet cannot be absolutely protected against intentional or malicious intrusion attempts. StriveIV™ does not control the third party sites and the Internet over which you may choose to send confidential personal or health information or other content and, therefore, StriveIV™ does not warrant any safeguard against any such interceptions or compromises to your information. When posting any content on an internet site, you should think carefully about your own privacy in disclosing detailed or private information about yourself and your family. Furthermore, StriveIV™ does not endorse any product, service, views or content displayed on the Social Media Site.

9.         This Social Media Usage Policy may be updated at any time without notice, and each time a user accesses a social networking site, the new policy will govern, usage, effective upon posting. By continuing to post any content after such new terms are posted, you accept and agree to any and all such modifications to this Social Media Usage Policy.

PRIVACY POLICY

StriveIV™

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

USES AND DISCLOSURES

Treatment.  Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health.

Health care operations.  Your health information may be used as necessary to review and adjust the day-to-day activities and management of StriveIV™. For example, information on the medical service you received may be used to support budgeting and financial reporting, fraud and abuse detection and compliance programs, and activities to evaluate and promote quality. We may also share your medical information with our “business associates” that perform the administrative service for us. We have a written contract with each of these business associates that contains terms requiring them and their subcontractors to protect the confidentiality and security of your medical information; provided, however, we are not responsible for any losses associated with or in connection with these providers.

Law Enforcement.  Your health information may be disclosed to law enforcement agencies, without your permission, to support government audits and inspections, to facilitate law-enforcement investigations, to comply with government mandated reporting and for other law enforcement purposes.

Public health reporting.  Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment (excluding any medical decisions), we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.

Required by Law.  As required by law in certain circumstances other than public health reporting, your health information may be used and disclosed by our staff, but such use and disclosure will be limited to the relevant requirements of the law concerning such specific circumstances. For example, we may be required to disclose information in the course of an administrative or judicial proceeding. Further, in the case of a breach of unsecured protected health information, to the extent required by law,  we will notify you as required by law.

ADDITIONAL USES OF INFORMATION

Appointment reminders.  Your health information will be used by our staff to send you appointment reminders, if available. We are not required to send appointment reminders.

Information about treatments.  Your health information may be used to send you information on the medical service that you may find to be of interest. We may also send you information describing other health-related goods and service that we believe may interest you.

OTHER USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION

Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing a use or disclosure of your information, you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision in writing.

INDIVIDUAL RIGHTS

You have certain rights under the federal privacy standards. These include:

•           The right to request restrictions on the use and disclosure of your protected health information by a written request specifying what information you want to limit, and what limitations on our use or disclosure of that information you wish to have imposed. We may not be required to agree to the restriction that you requested due to limitations contained in the applicable laws and we will notify you of our decision to reject your request;

•           The right to receive communications from us concerning your medical condition and treatment through reasonable, confidential alternative means selected by you;

•           The right to inspect and copy your protected health information. To access your medical information, you must submit a written request detailing what information you want access to, whether you want to inspect it or get a copy of it, and if you want a copy, your preferred form and format. We will provide copies in your requested form and format if it is readily producible, or we will provide you with an alternative format you find acceptable. We will charge a reasonable fee which covers our costs for labor, supplies, postage, and if requested and agreed to in advance, the cost of preparing an explanation or summary, as allowed by applicable law. We may deny your request under limited circumstances;

•           The right to amend or submit corrections to your protected health information by submitting a written request including the reasons you believe the information is incorrect or incomplete. We are not required to change your health information and will provide you with information regarding our denial of such requested amendment. If we deny your request, you may submit a written statement of your disagreement with that decision, and we may, in turn, prepare a written rebuttal;

•           The right to receive an accounting of how and to whom your protected health information has been disclosed; provided, however, we are not required to provide to you an accounting of disclosures made for the purposes of treatment, payment, health care operations, information provided directly to you, information provided pursuant to your written authorization, and certain government functions; and

•           The right to receive a printed copy of this notice.

STRIVEIV DUTIES

We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices. We also are required to abide by the privacy policies and practices that are outlined in this notice.

RIGHT TO REVISE PRIVACY PRACTICES

As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Whatever the reason for these revisions, we will provide you with a revised notice on your next office visit. We will also prominently post the current notice on our website. The revised policies and practices will be applied to all protected health information that we maintain, regardless of when it was created or received.

electronic signatures

You acknowledge and agree that your electronic submission or continued use constitutes consent to the terms contained herein.

REQUESTS TO INSPECT PROTECTED HEALTH INFORMATION

As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting the Compliance Officer at the telephone number and address set forth below.

COMPLAINTS

If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns. You also have the right to submit a complaint to the Secretary of the Department of Health and Human Service if you believe your privacy rights have been violated. Please see the address below.

If you believe that your privacy rights have been violated, you should call the matter to our attention by contacting the Compliance Officer at the telephone number set forth below, or by sending a letter describing the cause of your concern to the address set forth below.

You will not be penalized or otherwise retaliated against for filing a complaint.

severability

If any provision of this Agreement is unlawful or void, the remainder of the Agreement is valid and enforceable.

CONTACT PERSON

For further information concerning our privacy practices please contact:

Compliance Officer, (203) 496-5732, info@striveiv.com

StriveIV LLC

700 Canal Street

Stamford CT 06902

EFFECTIVE DATE

This notice is effective on September 1, 2017