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Patient Usage Agreement

Welcome to the Physicians at Sugar Creek Patient Portal.  The below information provides guidelines for intended use by patients and the opportunity to communicate with their health care provider through secure messages and electronic forms. A patient transmitting confidential information by e-mail, however has a number of risks, both general and specific that patients should consider before copying and sending secure messages through regular email.

General Risk Factors
- Email can be immediately broadcast worldwide and be received by many intended and unintended recipients.
- Recipients can forward email messages to other recipients without the original sender’s permission or knowledge.
- Users can easily misaddress an email.
- Backup copies of email may exist even after the sender or the recipient has deleted his or her copy.

Among specific patient email risks are the following
- Email containing information pertaining to a patient’s diagnosis and/or treatment must be included in the patient’s medical records. Thus, all individuals who have access to the medical record will have access to the email messages.
- Employees do not have an expectation of privacy in email messages they send or receive at their place of employment. Thus, patients who send or receive email from their place of employment risk having their employer read their email.
- If patients use a shared home email address with other members of their family and a shared password there is no guarantee of privacy. Email messages may be read by anyone who has access to your email account and share a password with you to that account.  It is highly recommended that each family member have an individual email account.

Content of Message
Email should be used only for non-urgent issues. Types of correspondence appropriate for email include:
·
Prescription refill requests
·
Appointment scheduling
·
Non-urgent medical follow-up (including some type of test results)
· Non-urgent medical correspondence

The following subject is never appropriate for e-mail: Any urgent medical problem or emergency

RESPONSE TIME
You should expect a response to your message in 2 business days with the exception of weekends, holidays or after hour responses.

ENDING PATIENT PORTAL RELATIONSHIP
Either you or your provider may request via email or letter to discontinue the use of the patient portal for communication.

CONDITIONS FOR THE USE OF E-MAIL
It is the policy of Physician’s at Sugar Creek to make all messages sent or received that concern the diagnosis or treatment of a patient part of that patient’s medical record and will treat such information with the same degree of confidentiality as afforded your other health information. Physician’s at Sugar Creek uses secure encryption for email correspondence.  We cannot, however, guarantee the security and confidentiality of email communication because of the risks outlined above.

CONSENT
I have read the above risks and I have received answers to all my questions about using email to communicate with Physician’s at Sugar Creek.  I understand that email communication initiated by me to Physician’s at Sugar Creek regarding my medical care will be interpreted as my having consented to receive email communication in reply.  I understand that any email that I send may be seen by people in the practice other than my doctor and that sending such communications across the Internet poses risk of loss of confidentiality of the information.  I understand that email is never appropriate for urgent or emergency situations.  I understand that if I communicate such sensitive information as AIDS/HIV infection; other sexually transmissible or communicable diseases such as syphilis, gonorrhea, herpes and the like; mental health or developmental disability; or alcohol and drug abuse there is no guarantee of  privacy.

I understand the terms outlined above and I ACCEPT the use of email in addition to electronic forms to communicate with Physician’s at Sugar Creek. I understand that either my physician or I may choose to discontinue the use of this service at any time.

OUR COMPANY AND ITS AFFILIATES, SUPPLIERS, AND OTHER THIRD PARTIES MENTIONED ON THIS SITE ARE NEITHER RESPONSIBLE NOR LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, EXEMPLARY, PUNITIVE, OR OTHER DAMAGES (INCLUDING, WITHOUT LIMITATION, THOSE RESULTING FROM LOST PROFITS, LOST DATA, OR BUSINESS INTERRUPTION) ARISING OUT OF OR RELATING IN ANY WAY TO THE SITE, SITE-RELATED SERVICES AND PRODUCTS, CONTENT OR INFORMATION CONTAINED WITHIN THE "SITE," AND/OR ANY HYPERLINKED WEB SITE, WHETHER BASED ON WARRANTY, CONTRACT, TORT, OR ANY OTHER LEGAL THEORY AND WHETHER OR NOT ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. YOUR SOLE REMEDY FOR DISSATISFACTION WITH THE SITE, SITE-RELATED SERVICES, AND/OR HYPERLINKED WEB SITES IS TO STOP USING THE SITE AND/OR THOSE SERVICES. APPLICABLE LAW MAY NOT ALLOW THE EXCLUSION OR LIMITATION OF INCIDENTAL OR CONSEQUENTIAL DAMAGES, SO THE ABOVE LIMITATION OR EXCLUSION MAY NOT APPLY TO YOU.