Terms of Service
Purpose
The purpose of this agreement is to assist you, the Client, in making an informed decision when determining whether to schedule a consultation with the understanding you will have to pay for this service.
This agreement is entered into between Integrated Holistic Care (IHC) and the Client upon ordering service. For the purpose of this Agreement, the term “Client” includes any representative(s) of the Client authorized to make decisions and sign this Agreement on the Client’s behalf.
Payment Agreement
The Client understands that payment for services rendered by Integrated Holistic Care is solely the Client's responsibility and requires private payment regardless of any insurance coverage. The Client agrees to pay for requested service(s) at the time of order using payment methods accepted by IHC. The Client acknowledges and accepts that the fees outlined do not include medication (cannabis) or other treatment, procedure, service, or product.
Services
Due to limited availability we are only taking new clients on a case-by case basis. Upon payment, you will be prompted to complete an intake form and submit any documents you wish to have considered. Once submitted, Janna will review the information, complete an assessment, and create an herbal medicine plan of care.
We DO NOT provide products or access to products!
Client Acknowledgements
I, the Client, acknowledge, understand, and accept that IHC does not provide or distribute herbal products.
I, the Client, voluntarily and knowingly consent to Integrated Holistic Care’s specialty telemedicine herbal medicine education services. By scheduling outpatient treatment, I agree to proceed and release any liability entailed to enable a distance consultation. I understand that the information furnished is for educational purposes only, and should not be construed as prescriptive, nor does this supersede nor replace any physician recommendations. I understand there is no implied or outright guarantee of experience and/or outcome.
I, the Client, understand it is the Client's responsibility to provide IHC and its professionals with accurate and complete medical history and description of the Client's condition and health status. The Client understands that, as with any service, to the extent that information provided is not accurate and complete, the services provided by IHC and its professionals may be materially affected and the Client assumes any risk, and takes full responsibility, and waives any claims against IHC and its professionals for personal injury, death, or damages.
I, the Client, acknowledge and accept that the scope and delivery of IHC services may be amended or modified at any time at the sole discretion of IHC.
I, the Client, accept responsibility for requesting and bearing the costs of copying any medical records necessary for IHC and its Professionals to provide services under this Agreement.
Term and Termination
This Agreement remains in effect throughout the Client’s continued communication and ongoing relationship with IHC and is effective immediately upon acceptance of Terms of Service. The Client may terminate this Agreement without cause upon written (711 Medford Center #153 Medford OR 97504) or electronic notice ([email protected]).
The purpose of this agreement is to assist you, the Client, in making an informed decision when determining whether to schedule a consultation with the understanding you will have to pay for this service.
This agreement is entered into between Integrated Holistic Care (IHC) and the Client upon ordering service. For the purpose of this Agreement, the term “Client” includes any representative(s) of the Client authorized to make decisions and sign this Agreement on the Client’s behalf.
Payment Agreement
The Client understands that payment for services rendered by Integrated Holistic Care is solely the Client's responsibility and requires private payment regardless of any insurance coverage. The Client agrees to pay for requested service(s) at the time of order using payment methods accepted by IHC. The Client acknowledges and accepts that the fees outlined do not include medication (cannabis) or other treatment, procedure, service, or product.
Services
Due to limited availability we are only taking new clients on a case-by case basis. Upon payment, you will be prompted to complete an intake form and submit any documents you wish to have considered. Once submitted, Janna will review the information, complete an assessment, and create an herbal medicine plan of care.
We DO NOT provide products or access to products!
Client Acknowledgements
I, the Client, acknowledge, understand, and accept that IHC does not provide or distribute herbal products.
I, the Client, voluntarily and knowingly consent to Integrated Holistic Care’s specialty telemedicine herbal medicine education services. By scheduling outpatient treatment, I agree to proceed and release any liability entailed to enable a distance consultation. I understand that the information furnished is for educational purposes only, and should not be construed as prescriptive, nor does this supersede nor replace any physician recommendations. I understand there is no implied or outright guarantee of experience and/or outcome.
I, the Client, understand it is the Client's responsibility to provide IHC and its professionals with accurate and complete medical history and description of the Client's condition and health status. The Client understands that, as with any service, to the extent that information provided is not accurate and complete, the services provided by IHC and its professionals may be materially affected and the Client assumes any risk, and takes full responsibility, and waives any claims against IHC and its professionals for personal injury, death, or damages.
I, the Client, acknowledge and accept that the scope and delivery of IHC services may be amended or modified at any time at the sole discretion of IHC.
I, the Client, accept responsibility for requesting and bearing the costs of copying any medical records necessary for IHC and its Professionals to provide services under this Agreement.
Term and Termination
This Agreement remains in effect throughout the Client’s continued communication and ongoing relationship with IHC and is effective immediately upon acceptance of Terms of Service. The Client may terminate this Agreement without cause upon written (711 Medford Center #153 Medford OR 97504) or electronic notice ([email protected]).
Health Insurance Portability and Accountability Act
Integrated Holistic Care Consultation Services
HIPAA Privacy Practices Notice
On April 14, 2003, a federal law called the “Health Insurance Portability & Accountability Act (HIPAA) took effect. This law governs how health care providers may use and disclose your medical information, and how you can access your own information. HIPAA requires that we notify you of our policy to protect the privacy of your medical information.
This notice of privacy practices applies to staff members at Integrated Holistic Care, Inc. who might handle sensitive health information. Your personal health information, to include any health information furnished or discussed with us, will be kept in a secure location and will be released to others only when you furnish written consent specifically allowing open sharing.
Your rights regarding your own medical information: You may request access to review your own medical information at any time, although charges may incur for copies that require administrative support. In accordance with Oregon state and federal laws, we will not release “specially protected information” regarding HIV testing, mental health counseling, or drug and alcohol dependence treatment records without your specific additional consent.
If at any time, you are concerned that we have compromised your medical information privacy, I invite you to discuss your concerns with me directly. Should we be unable to work together to resolve your concerns, you may contact the Secretary of the Department of Health and Human Services in Washington, DC. Your privacy is one of our greatest concerns, and we are committed to the security of your sensitive medical information.
Integrated Holistic Care Consultation Services
HIPAA Privacy Practices Notice
On April 14, 2003, a federal law called the “Health Insurance Portability & Accountability Act (HIPAA) took effect. This law governs how health care providers may use and disclose your medical information, and how you can access your own information. HIPAA requires that we notify you of our policy to protect the privacy of your medical information.
This notice of privacy practices applies to staff members at Integrated Holistic Care, Inc. who might handle sensitive health information. Your personal health information, to include any health information furnished or discussed with us, will be kept in a secure location and will be released to others only when you furnish written consent specifically allowing open sharing.
Your rights regarding your own medical information: You may request access to review your own medical information at any time, although charges may incur for copies that require administrative support. In accordance with Oregon state and federal laws, we will not release “specially protected information” regarding HIV testing, mental health counseling, or drug and alcohol dependence treatment records without your specific additional consent.
If at any time, you are concerned that we have compromised your medical information privacy, I invite you to discuss your concerns with me directly. Should we be unable to work together to resolve your concerns, you may contact the Secretary of the Department of Health and Human Services in Washington, DC. Your privacy is one of our greatest concerns, and we are committed to the security of your sensitive medical information.