Create Your Account
USER AGREEMENT AND AUTHORIZATION FOR USE OF MY INFORMATION BY WELLNESSFX, INC.
IMPORTANT: PLEASE READ THIS AGREEMENT CAREFULLY BEFORE CHECKING THE BOX.
By checking the box, you are indicating that you have read and understand this User Agreement (this "Agreement") on the "Create Your Account" web page, and are agreeing to the following terms as an agreement between you as a subscriber of the online services of WellnessFX, Inc. ("WellnessFX") and WellnessFX, and your checking the box is your indication that you assent to be bound by this Agreement. You are referred to in the following agreement as "I" or "me."
As a condition to my subscription to and my right to use WellnessFX Services defined below, WellnessFX and I agree as follows:
Access to WellnessFX Services. WellnessFX operates an online wellness service and manages a network system facilitating and enabling its subscribers ("Subscribers") to identify, engage, communicate with, and pay healthcare providers ("Health Advisors") to obtain laboratory diagnostic testing and medical advice regarding the results of such diagnostic tests and other wellness-oriented advice (the "WellnessFX Services"). The network system is a service intended to assist Subscribers by connecting them to Health Advisors, it is not a medical device and WellnessFX does not directly or indirectly practice medicine, nor does it dispense medical advice, diagnosis, treatment or any other medical service as part of the WellnessFX Services. Subject to the terms of this Agreement and my payment of the Services Fees (defined below), during the term of my subscription, WellnessFX grants me a non-sublicensable, non-transferable, non-exclusive subscription to access and use WellnessFX Services solely for my personal wellness, and not for resale or to provide services to third parties.
I agree that I will not, and will not attempt to: (a) interfere in any manner with the operation of WellnessFX Services, or the hardware and network used to operate WellnessFX Services; (b) sublicense or transfer any of my rights under this Agreement or otherwise use WellnessFX Services for the benefit of a third party or to operate a service bureau; (c) modify, copy or make derivative works based on any part of WellnessFX Services; (d) create Internet "links" to or from WellnessFX Services, or "frame" or "mirror" any of WellnessFX content which forms part of WellnessFX Services; or (e) otherwise use WellnessFX Services in any manner that exceeds the scope of use granted above. I agree to comply with the WellnessFX Services System Rules posted from time to time at www.WellnessFX.com or any web page accessed through that site.
I understand that there are risks presented by participating in using WellnessFX Services including receipt by me of information about my health (such as genetic or metabolic characteristics) that I would prefer not to know, and which may indicate conditions or problems that may be upsetting to me or even incurable, and I assume those risks.
Primary Care Physician. I represent and warrant that I am in good health, have had a recent health checkup, and have and will maintain a primary care physician, and I understand and agree that use of WellnessFX and Health Advisors is not a substitute for seeking the advice of my primary care physician or other qualified health care professionals. I agree that I will never delay seeking advice from my primary care physician or other health professionals due to information provided through WellnessFX or Health Advisors. I will seek emergency help when needed, and continue to consult with my primary care physician as recommended by Health Advisors and by my primary care physician.
Changes. WellnessFX Services, and the business, development and activities of WellnessFX, are subject to change during my subscription as determined from time to time by WellnessFX in its discretion. WellnessFX has no obligations to create or include additional features or functionality for WellnessFX Services or correct any errors. WellnessFX may modify the terms of this Agreement on at least 30 days notice, and if I do not accept such modified terms I agree that I may cancel my subscription, but if I do not cancel my subscription, I agree that I am bound to such modification.
Registration and Health Information. I have provided or will provide to WellnessFX personal information that may include my name, address, telephone number, fax number, email address, insurance information, and other information required by WellnessFX to register me as a Subscriber ("Registration Information"), and medical history, behavioral information, nutritional information and other health, family and personal background information ("Health Information"). Health Information that does not include any personally identifying information such as my name, the names of my health care providers and relatives, is my "De-Identified Information." I understand that I can update or revise my Registration Information and Health Information through a process available on WellnessFX website. I represent and warrant that (i) my Registration Information and Health Information will at all times be true, accurate and complete, and (ii) I am the person whose name and information I have provided and (iii) I am an adult 18 years of age or older residing in the United States.
Use of Services. Genetic, metabolic and other diagnostic testing by clinical laboratories ("Testing Laboratories") will be performed independent of WellnessFX Services and ordered by Subscribers in accordance with applicable state laws. I will submit samples to Testing Laboratories through a process established by Testing Laboratories and coordinated by WellnessFX from time to time, and I agree to execute waivers and authorizations that may be provided to me at the time my samples are collected. The samples I submit to Testing Laboratories may include blood, saliva, hair and other biological samples and are referred to as my "Laboratory Samples." I will not submit my Laboratory Samples directly to WellnessFX. I understand that diagnostic testing on my Laboratory Samples may be ordered by my Health Advisor at their discretion and the results will be received by my Health Advisor. Upon my execution of the proper consent and HIPAA Authorization, the results from such testing ("Testing Results") will also be sent to WellnessFX by Testing Laboratories to provide certain WellnessFX Services. I may also purchase other goods and services from third parties made available to me by WellnessFX ("Goods and Services").
Third Party Programs. I may subscribe for certain WellnessFX Services and Goods and Services through a program sponsored by a third party such as my employer, a group to which I belong or other third party. I understand that my subscription and participation through such program will be subject to the terms of such program, which may include provision to a third party administrator, your employer or other group information about me, including whether and to what extent I have participated. WellnessFX will not provide information regarding my health in a form that can be identified to me, without my specific approval through a click through or other “opt-in” mechanism.
Feedback. I may in my discretion choose to provide written or verbal feedback, comments, or input to WellnessFX relating to current or future WellnessFX Services or other opportunities for WellnessFX ("Feedback"). I hereby assign to WellnessFX all right, title and interest in any Feedback, including any Intellectual Property Rights (defined below) therein.
Costs and Payments. I acknowledge and agree that I will be responsible for all applicable fees for WellnessFX Services and the Goods and Services I purchase (the fees for WellnessFX Services are the "Services Fees") and for any applicable cancelation fees for cancelation of appointments without the required advance notice. Services Fees are established and subject to modification by WellnessFX from time to time as determined by WellnessFX. I understand that WellnessFX will bill me for all Services Fees and for all Goods and Services, and I will pay such invoices when they are due. WellnessFX may bill me in advance and may provide WellnessFX Services and Goods and Services only after I pay my outstanding bills. I acknowledge that the Services Fees do not include and I will be fully responsible for all charges for goods and services provided by Health Advisors to be established by Health Advisors (“Other Fees”) which will be invoiced to me and paid through the network system managed by WellnessFX. WellnessFX may provide a single invoice for all WellnessFX, Health Advisors and Testing Laboratories services, and I understand that such fees are separate and collected by WellnessFX as an agent or conduit for such Health Advisors and Testing Laboratories. By providing my credit card account information for payment of Services Fees and Other Charges, I represent and warrant that the credit card for which I provide account information is my credit card and I authorize WellnessFX to charge to such credit card all applicable charges for the WellnessFX Services, services of Health Advisors, and Goods and Services I have ordered.
No Medical or Health Services. I understand that WellnessFX is not a Health Advisor or a Testing Laboratory, and WellnessFX does not provide medical, health or other professional services or advice, nor does WellnessFX itself perform any testing on my samples to provide Testing Results. WellnessFX brings together Health Advisors and Subscribers while facilitating data gathering and conducting data analyses that may help Health Advisors and Subscribers work together to help Subscribers take a more active role in their well-being. I understand and agree that Health Advisors are not the employees, agents or subcontractors of WellnessFX and not providing services on behalf of WellnessFX, but instead are independent professionals solely responsible for the services each provides to me. WellnessFX does not practice medicine or any other licensed profession, and does not interfere with the practice of medicine or any other licensed profession by Health Advisors, each of whom is responsible for his or her services and compliance with the requirements applicable to his or her profession and license.
HIPAA Acknowledgment. I agree to provide a separate HIPAA AUTHORIZATION available at [https://wwws.wellnessfx.com/hipaa_authorization] before accessing WellnessFX Services, which WellnessFX is authorized to provide to my Health Advisors and Testing Laboratories but I understand that my Health Advisors and Testing Laboratories may require my execution of additional documents authorizing their disclosure of My Information. My Health Advisors and others I authorize will have access to My Information, and WellnessFX may use My Information as provided in this Agreement and my applicable HIPAA Authorization.
Limitations. NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY CONSEQUENTIAL, INDIRECT, INCIDENTAL, SPECIAL, PUNITIVE OR EXEMPLARY DAMAGES, OR FOR DIRECT DAMAGES IN AN AMOUNT GREATER THAN $10,000, EXCEPT FOR A VIOLATION OF SECTION 15. NEITHER WELLNESSFX NOR ITS OFFICERS, DIRECTORS, EMPLOYEES AND AGENTS ARE LIABLE FOR THE ACTIONS OR OMISSIONS OF TESTING LABORATORIES OR HEALTH ADVISORS, AND I HEREBY AGREE THAT I WAIVE ANY AND ALL CLAIMS AGAINST ANY OF THEM ARISING FROM OR RELATING TO THE SERVICES PROVIDED TO ME BY TESTING LABORATORIES OR HEALTH ADVISORS.
Termination. Unless earlier terminated pursuant to this Agreement, the term of this Agreement ("Term") will commence upon my checking the "Accept" box and will continue for the period of time I am a subscriber to WellnessFX Services. Either party may terminate this Agreement at any time on written notice with or without any reason. Upon termination:
a. WellnessFX will not thereafter share Registration Information with any other party.
c. My access rights to WellnessFX Services shall terminate.
d. All outstanding fees owed to WellnessFX and/or Health Advisors shall become due and payable.
e. All Sections which by their nature survive termination of this Agreement shall survive.
I understand that, upon termination, I will not receive any refund or partial refund for any charges already billed to my account. I understand and agree that termination of this Agreement is my sole right and remedy with respect to any dispute with WellnessFX. This includes, but is not limited to, any dispute related to, or arising out of: (1) any term of this Agreement or WellnessFX's enforcement or application of this Agreement; (2) any policy or practice of WellnessFX or WellnessFX's enforcement or application of these policies; (3) my ability to access and/or use WellnessFX Services; (4) any WellnessFX software or services provided by or through WellnessFX; or (5) the amount or type of fees, applicable taxes, billing methods, or any change to the fees, applicable taxes, or billing methods.
Notices. If there is an actual or suspected breach of the security of My Information, or any unpermitted disclosure or use of My Information, and WellnessFX is required to provide notice of such actual or suspected breach or unpermitted disclosure or use to me under applicable federal or state law I hereby agree that, if allowed by law, such notice may be provided by WellnessFX by email to the email address provided by me during my member registration, or as updated by me thereafter by written notice to WellnessFX.
No Warranties. ALL SERVICES AND PRODUCTS PROVIDED BY WELLNESSFX ARE PROVIDED "AS-IS" WITHOUT ANY WARRANTY EXPRESS OR IMPLIED, AND WELLNESSFX DISCLAIMS ALL IMPLIED WARRANTIES, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A SPECIFIC PURPOSE. Without limiting the preceding sentence, I acknowledge and agree that WellnessFX is not responsible for the actions or omissions of my Health Advisors or Testing Laboratories.
Ownership. WellnessFX owns all right, title and interest to its software, processes, methodologies, documents and other materials, and all patent, copyright, trademark, and other rights of any nature arising from or relating in any way thereto ("Intellectual Property Rights"). No right to the Intellectual Property Rights of WellnessFX is granted to me except to permit me to use WellnessFX Services as a Subscriber.
Severability. Any provision of this Agreement determined to be void, invalid or unenforceable will be deemed modified to the minimum extent necessary to be effective, valid and enforceable, and the other provisions of this Agreement will in full force and effect and enforceable according to their terms.
Binding Arbitration and Equitable Relief. Any dispute arising under or relating in any way to this Agreement will be resolved exclusively by final and binding arbitration in San Francisco, California under the rules of the American Arbitration Association, except as set forth in the next sentence. Pending resolution by such final and binding arbitration, either party is entitled to seek temporary and preliminary specific performance and injunctive relief in any court of competent jurisdiction, without the posting of bond or other security, and the parties agree to the personal and subject matter jurisdiction and venue of the courts located in San Francisco, California, for any such action.
HIPAA Privacy Authorization Form
Authorization for Use or Disclosure of Protected Health Information (Required by the Health Insurance Portability and Accountability Act – 45 CFR Parts 160 and 164 and California Civ. Code § 56.11)
I hereby authorize all health care providers (“Health Advisors”) and testing laboratories (“Testing Labs”) that provide services to me in connection with my subscription to services provided by WellnessFX, Inc. (“WellnessFX”) to use and/or disclose the protected health information described below to WellnessFX as follows.
Authorization for Release of Information. I hereby authorize the release of my complete health record contained in my account with WellnessFX (including without limitation all Health Advisor notes and diagnoses and Testing Labs results and the information I have contributed to my health record contained within my account), covering all past, present and future periods,
This health information may be used by WellnessFX in order to provide the WellnessFX services that I subscribed to and for any other uses that I consent to from time to time pursuant to the policies and agreements applicable to my subscription to services provided by WellnessFX.
This authorization shall be in force and effect until I revoke it in accordance with the terms below.
I understand that I have the right to revoke this authorization at any time by providing written notice to email@example.com. I understand that a revocation is not effective to the extent that any person or entity has already acted in reliance on my authorization or if my authorization was obtained as a condition of obtaining insurance coverage and the insurer has a legal right to contest a claim. I further understand that, upon my revocation, my Health Advisors and Testing Labs will no longer be able to disclose my health information to WellnessFX, and that the WellnessFX services therefore will no longer be available to me.
I understand that my treatment, payment, enrollment or eligibility for benefits will not be conditioned on whether I sign this authorization. However, I understand that failure to provide this authorization will prevent my Health Advisors and Testing Labs from disclosing my health information to WellnessFX, and that the WellnessFX services therefore will not be available to me.
I understand that information used or disclosed pursuant to this authorization may be disclosed by the recipient and may no longer be protected by federal or state law.
I understand I have the right to receive a copy of this authorization by sending a written request to firstname.lastname@example.org.