Effective Date: June 9, 2019
Updated: April 23, 2020
These Medical Terms of Service (“Medical Services Terms”) govern your use of the medical services (“Medical Services”) provided by Pacific Crest Children’s Urgent Care, LLC (“Practice”), an affiliate of Brave Care, Inc. (“Brave Care, Inc.”), and by other affiliated medical services providers (collectively with Practice “Brave Care Providers”) and in some regions where the Brave Care Providers are subcontractors for a health system or academic medical center partner (“Provider Partner(s)”). These Provider Partner relationships are described in more detail in Section 8 below. If you are using Medical Services in a region identified in Section 8, the applicable Provider Partner is also a party to these Medical Services Terms. Please read these Medical Terms of Service carefully before using Brave Care Provider’s Medical Services.
By clicking the “check box” on the website or app as the registered user, or by signing below as either the patient, or patient’s legal representative, guardian, conservator, or custodian of a minor child (under 18 years of age) or other person lacking the ability to consent (collectively “You”), You acknowledge to have read, accepted and become legally bound to the terms and conditions set forth below and in the Consent to Treat via Telehealth. In the event of conflict, the terms of the Consent to Treat via Telehealth shall control all Medical Services provided via telehealth. The terms “You” or “you” shall also mean the patient or recipient of health care services.
Brave Care, Inc. and Brave Care Providers are collectively referred to as “Brave Care.”
Please refer to our Notice of HIPAA Privacy Practices to learn how Brave Care collects, uses, shares and protects your Protected Health Information (as defined under the Health Insurance Portability and Accountability Act of 1996).
Please do NOT use the Medical Services, including the Telehealth Services, for emergency or life threatening medical matters. For all life threatening matters, you must immediately call 911 or go to the nearest emergency room.
Brave Care may, in its sole discretion, without prior notice to you, revise these Medical Service Terms at any time. Should these Medical Service Terms change materially, Brave Care will update the Effective Date noted above and post a notice regarding the updated Terms. If you do not agree with the proposed changes, you should discontinue your use of the Medical Services before the effective date of the change. If you continue using the Medical Services after the effective date, you will be bound by the updated Medical Services Terms.
You agree to pay Brave Care all applicable charges at the prices then in effect for the Medical Services provided to you or another person on whose behalf you are accepting these Medical Services Terms and payment responsibility (such as your children or other family members) (“Covered Family Member”). You will be charged for the Medical Services, including complementary and alternative services provided to you or your Covered Family Member by a Brave Care Provider. You authorize Brave Care to charge your chosen payment method (your “Payment Method”) for the Medical Services provided to you or your Covered Family Member. If your Payment Method is invalid at the time payment is due, you agree to pay all amounts due upon demand. The third-party services provider who manages your Payment Method may impose terms and conditions on you, which are independent of these Medical Services Terms and you agree to comply with all of those terms. Brave Care may accumulate charges that you’ve incurred for the Medical Services and submit them as one or more aggregate charges during or at the end of each billing cycle. Brave Care reserves the right to correct any billing errors or mistakes even if payment has already been requested or received.
If you provide information about your health insurance or health plan, that will be deemed your authorization for us to submit claims for covered Medical Services to your health insurer or health plan. You hereby assign or otherwise authorize payment of medical benefits to us for the Medical Services provided to you or your Covered Family Member. You authorize the release of any medical or other information necessary to process any claims for the Medical Services provided. You further understand and accept your financial responsibility for any portion of the bill not covered by your health insurer or health plan. SUBMISSION OF CHARGES DOES NOT WAIVE OUR RIGHT TO SEEK PAYMENT DIRECTLY FROM YOU.
You give permission to the Brave Care Providers to medically care for your Covered Family Member or you. You may withdraw this consent at any time by no longer seeking Medical Services from Brave Care.
You understand and agree that as part of providing Medical Services to your Covered Family Member or you, your PHI, including test results, may be released to an online personal health record and via communication with Brave Care’s healthcare team electronically (in accordance with our Notice of HIPAA Privacy Practices and Consent to Treatment via Telehealth).
You may terminate your use of the Medical Services at any time by not using the Medical Services any more. We may terminate your use of the Medical Services at any time in our reasonable discretion, for causes including but not limited illegal conduct such as falsifying information to obtain controlled substances, abusive and threatening behavior, and continued refusal to pay for our services. We may terminate your use of the Medical Services by sending notice to you at the mail or email address you provided to us or by otherwise contacting you. If we terminate your use of the Medical Services, we will use reasonable effort to notify your insurer, if any.
You agree that Brave Care may send the following to you by email or by posting them on our website and mobile application: legal disclosures; these Medical Services Terms, Consent to Treatment via Telehealth, Notice of HIPAA Privacy Practices; future changes to any of the above; and other notices, policies, communications or disclosures and information related to the Medical Services.
By clicking the “check box” on the website or app as the registered user, You agree that Brave Care may contact you via messaging (secure), email, phone, text, or mail regarding the Medical Services, including electronic communications from Brave Care pertaining to your care and your health, which may include PHI. You understand that communication via email, text messages, and other electronic means selected by Brave Care may not be secure and could be viewed by unintended persons, and you or on behalf of your Family Member agree to exchange of communications, to and from Brave Care via these electronic means. You agree to update your contact information to ensure accuracy.
If you later decide that you do not want to receive certain future communications electronically, please send an email to email@example.com or a letter to Brave Care, Brave Care, Inc., 6924 NE Sandy Blvd, Portland, OR 97213. You may also opt out of certain electronic communications through your account or by following the unsubscribe instructions in any communication you receive from Brave Care. Your withdrawal of consent will be effective within a reasonable time after we receive your withdrawal notice described above.
Brave Care will need to send you certain communications electronically regarding the Medical Services. You will not be able to opt out of those communications – e.g., communications regarding updates to these Medical Services Terms or information about billing. Your withdrawal of consent will not affect the legal validity or enforceability of the Medical Services Terms provided to and accepted by, you.
TO THE MAXIMUM EXTENT NOT PROHIBITED BY LAW, EXCEPT IN CASE OF NEGLIGENCE OR WILLFUL MISCONDUCT, WE AND OUR AFFILIATES, BRAVE CARE PROVIDERS, PARTNER PROVIDERS, EMPLOYEES, OFFICERS, DIRECTORS OR AGENTS WILL NOT BE RESPONSIBLE FOR ANY LOSS OR DAMAGE, INCLUDING PERSONAL INJURY OR DEATH, RESULTING FROM ANYONE’S USE OF OR INABILITY TO USE THE MEDICAL SERVICES.
The Medical Services are intended for use only within the United States and its territories. We make no representation that the Medical Services are appropriate, or are available for use outside the U.S. Those who choose to access and use our Medical Services from outside the U.S. do so on their own initiative, at their own risk, and are responsible for compliance with applicable laws.
TO THE MAXIMUM EXTENT NOT PROHIBITED BY LAW, IN NO EVENT WILL WE AND OUR AFFILIATES, BRAVE CARE PROVIDERS, PARTNER PROVIDERS, EMPLOYEES, OFFICERS, DIRECTORS OR AGENTS BE LIABLE FOR ANY CONSEQUENTIAL, EXEMPLARY, INCIDENTAL, SPECIAL OR PUNITIVE DAMAGES, INCLUDING WITHOUT LIMITATION THOSE RELATING TO LOST PROFITS OR THE COST OF SUBSTITUTE PRODUCTS OR SERVICES ARISING OUT OF OR IN CONNECTION WITH THE MEDICAL SERVICES OR FROM THE USE OF OR INABILITY TO USE THE MEDICAL SERVICES, WHETHER BASED ON CONTRACT, WARRANTY, PRODUCT LIABILITY, TORT OR OTHER LEGAL THEORY AND EVEN IF WE HAVE BEEN INFORMED OF THE POSSIBILITY OF SUCH DAMAGES. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR CONSEQUENTIAL OR INCIDENTAL DAMAGES, SO THE ABOVE EXCLUSION MAY NOT APPLY TO YOU.
Brave Care has partnered with select health systems and academic medical centers in some of our markets. As the result, for Medical Services, with the exception of Telehealth Services, in the following markets, these Medical Services Terms are modified as set for the below. Each of the Provider Partners identified in this section is deemed to be a party to these Medical Services Terms, with the exception of Section 9 Telehealth Services and Permission, as they relate to Medical Services provided by the Partner in the corresponding regions identified below.
Portland - Pacific Crest Children’s Urgent Care
Separate from its Regional Partners, Brave Care may directly provide Medical Services to you or your Covered Family Member using virtual technology when the Brave Care Provider and patient are not in the same physical location (the “Telehealth Services”). Telehealth may be used for diagnosis, treatment, care, follow-up and/or patient education, and may include, without limitation, the following: electronic transmission of patient medical records, medical images, and/or other patient data or information; synchronous (i.e., “real time”) and asynchronous (i.e., non-”real time”) interactions via audio, video, text, and/or data or other electronic communications; automated, electronic or digital tools or services for diagnosis, care, treatment and/or communication pertaining to healthcare or medical matters; and output, transmission or exchange of data from medical devices, sound and video files.. You understand that virtual encounters with Brave Care’s Telehealth Services via phone, email, video, or otherwise, could involve certain limitations and risk, such as unauthorized disclosure of PHI, and you hereby consent to the use of, automated tools for diagnosis, care, treatment or communication pertaining to healthcare matters. You also acknowledge that such virtual encounters may involve care by a variety of Brave Care Providers, including physicians, registered nurses, nurse practitioners, physician assistants, nutritionists, naturopathic doctors, therapists, and other support or medical personnel in accordance with applicable laws and regulations.
Unless you object, you give permission to Brave Care Providers to record and process your personal details and medical data generated during the provision of Telehealth Services. You may withdraw these permissions at any time by no longer seeking Telehealth Services from Brave Care.
You agree to the following terms with respect to use of the Telehealth Services:
If you have any questions about these Medical Services Terms, please contact firstname.lastname@example.org.