Breezefast is a limited liability company that provides healthcare services using interactive video and technologies remotely, in which case both parties are not in same physical location. Breezefast contracts with physicians and allied medical professionals-Nurse Practitioners and Physician Assistant to provide medical services to individuals residing in Florida, California, New York, Washington DC. Please note the term “Doctors” refers to our team of physicians, Nurse Practitioner and Physician Assistant. Breezefast service is considered consultation services even if you continue to use the services for additional acute cases. You should seek emergency help or follow-up care when recommended by any of our providers, continue to consult with your primary care providers as recommended. This service does not replace your continued relationship with your primary care provider.
Telehealth involves the delivery of healthcare services using electronic communications, information technology or other means between a medical provider and a patient who are not in the same physical location. Telehealth may be used for diagnosis, treatment, follow-up and/or patient education, and may include, but is not limited to, one or more of the following: Electronic transmission of medical records, photo images, personal health information or other data between a patient and a medical provider. Interactions between a patient and medical provider via audio, video and/or data communications.
Breezefast will communicate with patients using audio, video, text communication. The use of telehealth and other technology by our medical provider may have the following possible benefits: -Ease and accessibility to medical care and treatment for acute conditions and some chronic conditions. -Convenient interaction with medical professional without the necessity of an in-office appointment. Possible Risks: Just like in any case, benefits of our services are improved access to healthcare and convenience. However, as with any health service, there are potential risks associated with the use of telehealth which includes: -Information given may be insufficient for the medical professional to make accurate medical plan, treatment. -
Our medical professionals may not be able to provide medical treatment for your particular condition and you may be asked to seek alternative healthcare or emergency care services. - lack of access to all of your health records may result in adverse drug interactions or other errors. -Technology failure may impact our medical professional’s ability to correctly diagnose or treat your medical condition. -The inability to obtain vital signs, or in-person assessment may prevent our medical professional from providing a diagnosis or treatment or from identifying the need for emergency medical care or treatment for you. - At Breezefast we incorporate strong security protocols to protect the confidentiality of your health information, in some instances, security protocols can fail, causing a breach of confidentiality. -Your condition may not be cured or improved. There are potential risks to the use of telehealth and other technology, including but not limited to the risks described in this Agreement. You have the right to withdraw your consent to the use of telehealth and technology in the course of your care at any time, which you may exercise by providing written notice to Breezefast LLC 4532 W. Kennedy Blvd, Suite 175, Tampa, FL 33609. Any withdrawal of your consent will be effective upon receipt of the written notice described above, except that such withdrawal will not have any effect on any action taken by Breezefast. By accepting this consent, you acknowledge that you understand and agree with the following:
• You understand that it is your duty to provide Breezefast and your medical professional truthful, accurate and complete information, including all relevant information regarding care that you may have received or may be receiving from healthcare providers other than Breezefast.
• Our medical professionals may share your health records with other health care providers for purposes relating to the provision, coordination or management of your healthcare so that we can meet your healthcare needs. This may include information relating to substance abuse, mental health, communicable diseases and other health conditions, subject to our terms.
• We may determine that our clinical services are not appropriate for some or all of your treatment needs and may elect not to provide clinical services to you through the Site.
• You acknowledge that some photographic or other images you submit to Breezefast via the Service or otherwise, and that will be shared with healthcare professionals may include portions of all of your breast or genitalia, and you hereby agree to the receipt of such images by our medical professionals solely for the purposes of providing you medical care and treatment. You represent that (a) you have read this Agreement carefully, (b) you understand the risks and benefits of the use of telehealth and other technology, including the Service, in the medical care and treatment provided to you by our medical professionals and (c) you have the legal capacity and authority to provide this consent for yourself.
Electronic Transmission When you use any Breezefast Service, or send e-mails, text messages, and other communications from your desktop or mobile device to us, you are communicating with us electronically. You consent to receive communications from us electronically. You agree that (a) all agreements and consents can be signed electronically and (b) all notices, disclosures, and other communications that we provide to you electronically satisfy any legal requirement that such notices and other communications be in writing.
Breezefast provides you with access to some aspects of your medical records which may include diagnosis, labs, medications and other health data gathered by Breezefast and information provided by you. Payment Terms. Breezefast is a concierge service which means that patients are responsible for payment of service provided, we do not bill third party such as insurance companies. You have the option of one-time payment in which a single service is provided or you may choose a monthly subscription that gives you unlimited access to a medical professional in a month, but note that this service still does not replace establishing a primary care provider relationship. We will only manage your acute symptoms and some intermittent chronic symptoms.
Breezefast also offers company sponsored program for employees and group plans. If you choose the monthly membership subscription, we may ask you to supply additional information relevant to your purchase, including, without limitation, your credit card number, the expiration date of your credit card and your billing address. You represent and warrant that you have the legal right to use all payment method information given. When you initiate a purchase, you authorize us to provide your payment Information to our third-party payment processors so we can complete your purchase and charge your payment method for the service you have selected. By agreeing to this Agreement and selecting monthly membership, you acknowledge that your membership has recurring payment features and you accept responsibility for all recurring payment obligations prior to cancellation of your membership subscription by you or Breezefast. Your membership subscription continues until cancelled by you or we terminate your subscription in accordance with this Agreement. In the event that your credit card expires, and our third-party payment processors are unable to process your payment, you may receive notice for you to provide an alternative payment method. You will not be able to receive any service unless you pay in full for the specific membership type you selected. Also note that our service fee is subject to change. You may cancel your monthly membership plan at any time. You may still use our service until end of the already paid billing month. To cancel your service, please send us an email at email@example.com
IN NO EVENT SHALL BREEZEFAST BE LIABLE TO YOU OR ANY OTHER PERSON OR ENTITY FOR ANY DAMAGES (INCLUDING, WITHOUT LIMITATION, INCIDENTAL AND CONSEQUENTIAL DAMAGES, PERSONAL INJURY OR WRONGFUL DEATH, LOST PROFITS, OR DAMAGES RESULTING FROM LOST OR CORRUPTED DATA OR BUSINESS INTERRUPTION) RESULTING FROM THE USE OF OR INABILITY TO USE ANY TECHNOLOGY. BREEZEFAST SHALL NOT BE LIABLE FOR ANY PERSONAL INJURY, INCLUDING DEATH, CAUSED BY YOUR USE, MISUSE OR INABILITY TO USE OUR SERVICE.YOU AGREE TO YOUR WAIVER OF ANY RIGHT TO PARTICIPATE IN A CLASS ACTION SUIT AGAINST BREEZEFAST FOR ANY LOSSES OR DAMAGES RESULTING FROM YOUR USE OF OUR SERVICES. TO THE EXTENT ANY ASPECTS OF THE FOREGOING LIMITATIONS OF LIABILITY ARE NOT ENFORCEABLE, THE MAXIMUM LIABILITY OF BREEZEFAST TO YOU WITH RESPECT TO YOUR USE OF THIS SITE IS $1,000 (ONE THOUSAND DOLLARS)..
Binding Arbitration, Dispute Resolution/ Class Waiver. Breezefast will try work with you in good faith to resolve any issue you have with our medical professionals, controversies and claims related to this Agreement, any medical care or treatment provided by our medical professionals including any allegations of medical malpractice if you bring that issue to our attention by writing to Breezefast LLC 4532 W. Kennedy Blvd, Suite 175, Tampa, FL 33609 or email to firstname.lastname@example.org. In the event we cannot resolve a dispute between us, including any allegations of medical malpractice, shall be finally and exclusively resolved by binding arbitration as described in this Section, which may be initiated by either party by sending a written notice requesting arbitration to the other. YOU
EXPRESSLY AGREES THAT ANY CLAIM, INCLUDING ANY CLAIM RELATING TO THE APPLICABILITY, ENFORCEABILITY OR VALIDITY OF ANY PROVISION OF THIS AGREEMENT (COLLECTIVELY “DISPUTES”), SHALL BE RESOLVED IN CONFIDENTIAL BINDING ARBITRATION CONDUCTED BEFORE ONE COMMERCIAL ARBITRATOR FROM THE AMERICAN ARBITRATION ASSOCIATION (“AAA”), RATHER THAN IN A COURT, AS DESCRIBED HEREIN. THE ARBITRATION WILL BE GOVERNED BY THE AAA'S COMMERCIAL ARBITRATION RULES AND, IF THE ARBITRATOR DEEMS THEM APPLICABLE, THE SUPPLEMENTARY PROCEDURES FOR CONSUMER RELATED DISPUTES (COLLECTIVELY “RULES AND PROCEDURES”). YOU ACKNOWLEDGE THAT YOU ARE VOLUNTARILY AND KNOWINGLY FORFEITING YOUR RIGHT TO A TRIAL BY JURY AND TO OTHERWISE PROCEED IN A LAWSUIT IN STATE OR FEDERAL COURT.
Payment of arbitration costs will be governed by the AAA’s fee schedule, unless you are able to show that your portion will be prohibitive as compared to litigation costs, in which case Breezefast will pay as much of your arbitration costs as the arbitrator deems necessary to prevent the arbitration from being cost-prohibitive as compared to litigation costs. Breezefast also reserves the right in its sole and exclusive discretion to assume responsibility for all arbitration costs imposed by the AAA. Each party agrees to pay its own attorneys’ fees and expenses unless there is a governing statutory provision that requires the prevailing party to be paid attorneys’ fees and expenses.The arbitration shall be conducted in Tampa, Florida, unless the parties agree otherwise in writing. The arbitrator’s award shall be final and binding on all parties and may be entered as a judgment in any court of competent jurisdiction. For more information on AAA, its Rules and Procedures, and how to file an arbitration claim, you may call AAA at 800-778-7879 or visit the AAA website at www.adr.org. All Disputes shall be resolved by binding confidential arbitration on an individual basis. You expressly agree that no other Disputes shall be consolidated or joined with your Dispute, whether through class arbitration proceedings or otherwise.
THE PARTIES AGREE THAT THERE IS NO RIGHT OR AUTHORITY FOR ANY DISPUTE TO BE ARBITRATED ON A CLASS-ACTION BASIS OR TO UTILIZE CLASS ACTION PROCEDURES, THERE IS NO RIGHT OR AUTHORITY FOR ANY DISPUTE TO BE BROUGHT IN A PURPORTED REPRESENTATIVE CAPACITY OR AS A PRIVATE ATTORNEY GENERAL, AND NO ARBITRATION SHALL BE JOINED WITH ANY OTHER ARBITRATION.
INFORMATION BY SIGNING, YOU ACKNOWLEDGE THAT YOU HAVE READ, ACCEPTED, AND AGREED TO BE BOUND BY THIS PATIENT AUTHORIZATION. YOU HEREBY GRANT AGENCY AUTHORITY TO ANY PARTY WHO SIGNS ON YOUR BEHALF. IN THIS AUTHORIZATION, THE TERMS “I”, “MY” AND “YOU” REFER TO THE PERSON WHO IS CREATING A PATIENT ACCOUNT, Information Covered by this Authorization: The information and data covered by this authorization includes all information or data that you submit to Breezefast or is collected on Breezefast behalf in connection with your treatment by Breezefast, including
(1) personally identifying information such as your name and contact data such as your e-mail address, phone number, and billing and physical addresses;
Breezefast is permitted to use and disclose “protected health information” (“PHI”) in certain ways without obtaining any patient consent or authorization, but must obtain patient authorization for certain uses and disclosures as required by HIPAA. What information do we collect-(1) personally identifying information such as your name and contact data such as your e-mail address, phone number, and billing and physical addresses; (2) your login and password; (3) demographic data (such as your gender, date of birth and zip code); (4) your communications with Breezefast providers and employees; (5) any information you provide when you contact or communicate with Breezefast such as image, documents, contact us or make customer service request (6) payment information; (7) health and medical data (such as previous doctors or other healthcare providers you visited, your reason for visiting a healthcare provider, date of visit, medical history and condition, medications, images or videos and other medical and health information and data you share with Breezefast or that is collected on Breezefast’s behalf) (collectively, “Covered Information”).