Last updated: August 16th, 2021
These Terms and Conditions govern your use of the forgehealth.com website (the “Website”).
Information Management/ HIPAA Compliance Policy and Procedure Manual
Title: Notice of Privacy Practices
1. OUR DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION
Individually identifiable information about your past, present, or future health information, the provision of health care to you, or payment for the health care is considered “Protected Health Information” (“PHI”). Forge Health is required to extend certain protections to your PHI, and to provide notice about our privacy practices that detail how, when, and why we may use or disclose your PHI. Except in specified circumstances, we must use or disclose only the minimum necessary PHI to accomplish the purpose of the use or disclosure. We are required to follow the privacy practices described in this Notice, though we reserve the right to change our privacy practices and the terms of this Notice at any time. If we do so, we will post a new notice.
2. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
For most PHI uses/disclosures, we are required to obtain your written authorization. However, we are legally permitted to make some uses/disclosures without your consent or authorization. Please see below for potential uses and disclosures of your PHI.
A. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations
Generally, we must have your consent to use/disclose your PHI except in the following circumstances:
- For services: We may disclose your PHI to staff members, volunteers, and other service delivery personnel who are involved in providing your services.
- To obtain payment: We may use/disclose your PHI in order to bill and collect payment for your services. You have the right to restrict disclosure to insurers if services are paid in full and out of pocket.
- For service operations: We may use/disclose your PHI in the course of operating our agency.
- Correspondence: Unless you provide us with alternative instructions, we may send materials such as bills or surveys to your home. We may also contact you for an appointment reminder for your initial evaluation.
- Exceptions: Although your consent is usually required for the use/disclosure of your PHI, Forge Health is legally authorized to use/disclose your PHI without your consent in emergency situations or when required by law.
B. Uses and Disclosures Requiring Authorization:
For uses and disclosures beyond treatment, payment, and al functions, including most use and disclosure of clinical information/documentation, we are required to have your written authorization, unless the use or disclosure falls within one of the exceptions described in subsection C. Your written authorization will be obtained for the use and disclosure of PHI for marketing purposes and disclosures that constitute a sale of Authorizations can be revoked at any time to stop future uses/disclosures except to the extent that we have already undertaken an action in reliance upon your authorization.
C. Uses and Disclosures Not Requiring Consent or Authorization: Forge Health is legally permitted to use/disclose your PHI without consent or authorization in the following circumstances:
- When required by law: We may disclose PHI when we are legally required to report information about suspected abuse, neglect or domestic violence, or relating to suspected criminal activity, or in response to a court order. We must also disclose PHI to authorities who monitor compliance with these privacy requirements.
- For public health activities: We may disclose PHI when we are required to collect information about disease or injury, or to report vital statistics to the public health authority.
- For health oversight activities: We may disclose PHI to an accrediting organization or another agency responsible for monitoring the health care system.
- Relating to decedents: We may disclose PHI relating to an individual’s death to coroners, medical examiners or funeral directors.
- For research purposes: In certain circumstances, and under supervision of a privacy board, we may disclose PHI to other agencies in order to assist medical/psychiatric research.
- To avert threat to health or safety: In order to avoid a serious threat to health or safety, we may disclose PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm.
- For specific government functions: We may disclose PHI of military personnel and veterans in certain situations, to correctional facilities in certain situations, to government programs relating to eligibility and enrollment, and for national security reasons, such as protection of the President.
3. YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION. YOU HAVE THE FOLLOWING RIGHTS RELATING TO YOUR PROTECTED HEALTH INFORMATION:
- To request restrictions on uses/disclosures: You have the right to ask that we limit how we use or disclose your PHI. We will consider your request but are not legally bound to agree to the restriction. To the extent that we do agree to any restrictions on our use/disclosure of your PHI, we will put the agreement in writing and abide by it except in emergency situations. We cannot agree to limit uses/disclosures that are required by law. You have the right to restrict disclosure to insurers if services are paid in full out of pocket. If you chose to restrict disclosure to your insurer, please send a letter with your request to the Forge Health Corporate Office at 1133 Westchester Avenue, Suite N-006 White Plains, New York 10605 Attn: Benji Knafo
- To choose how we contact you: You have the right to ask that we send you information at an alternative address or by an alternative means. We must agree to your request, provided the request is reasonable.
- To inspect and copy your PHI: Unless your access is restricted for clear and documented treatment reasons, you have a right to see your protected health information if you put your request in writing. We will respond to your request within 30 days. If we deny your access, we will give you written reasons for the denial and explain any right to have the denial reviewed. If you want copies of your PHI, a charge for copying may be imposed, but also may be waived, depending on your circumstances. You have a right to choose what portions of your information you want copied and to have prior information on the cost of copying. You have the right to an electronic copy of electronic information.
- To request amendment of your PHI: If you believe that there is a mistake or missing information in our record of your PHI, you may request, in writing, that we correct or add to the record. We will respond within 60 days of receiving your request. We may deny the request if we determine that the PHI is: (i) correct and complete; (ii) not created by us and/or not part of our records, or; (iii) not permitted to be disclosed.
- Disclosure Accounting: You have a right to get a list of when, to whom, for what purpose, and what content of your PHI has been released, other than instances of disclosure for which you have given prior consent (i.e. for treatment, payment, operations, to you, or your family,). The list also will not include any disclosures made for national security purposes, to law enforcement officials or correctional facilities. We will respond to your written request for such a list within 60 days of receiving it. Your request can relate to disclosures going as far back as six years. There will be no charge for up to one such list each year. There may be a charge for more frequent requests.
- To be notified following a breach: You have the right to be notified following a breach of unsecured protected health information.
- To receive this notice: You have a right to receive a paper copy of this Notice.
4. HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES:
If you think we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed in Section V below. You also may file a written complaint with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Ave., SW, Washington, D.C. 20201. We will take no retaliatory action against you if you make such complaints.
5. CONTACT PERSON FOR INFORMATION, OR TO SUBMIT A COMPLAINT:
If you have questions about this Notice or any complaints about our privacy practices, please contact: Benjamin Knafo, Head of Human Relations, (914) 886-3656
General Statement on Privacy, Personal Data, and Communications
When you visit the Website, or communicate with Forge, via email, you are communicating electronically. You consent to receive communications from Forge Health electronically. Forge Health will communicate with you by email or by posting notifications on the Website. You understand and agree that all agreements, notices, disclosures, and other communications that Forge Health provides electronically satisfy any legal requirement that such communications be in writing.
User Provided Information
Forge Health may collect personally identifiable information (“PII”) about individuals – such as names and postal codes, home addresses, and email addresses – only when such information is knowingly provided to Forge Health. PII may be transmitted as part of a form submission or in connection with services made available on the Website. Any PII retrieved by Forge Health must be voluntarily submitted by the user.
Forge Health may use the information provided to contact you with important information, required notices, and marketing promotions.
Forge Health is concerned about safeguarding the confidentiality of your information. We provide physical, electronic, and procedural safeguards to protect information we process and maintain. For example, we limit access to this information to authorized employees and contractors who need to know that information in order to operate, develop or improve the Website. Please be aware that, although we endeavor to provide reasonable security for information we process and maintain, no security system can prevent all potential security breaches.
How Information is Used
The following is an example of how Forge Health might use PII that may be collected through the Website:
* If you indicate that you are interested in receiving Forge Health related news and information, you may receive emails to the email address you provided as part of the registration process.
For the non-personally identifiable information that may be collected through the Website:
* Aggregate data could be analyzed to describe the collective characteristics and behaviors of online visitors, and subsequently be used to further optimize the effectiveness of the website, and the overall Forge Health experience.
You can help Forge Health maintain the accuracy of your personal information by updating your account. Please update this information when you change your address, phone number, or email address. Forge Health will never share telephone numbers, email addresses, or any personal data with third parties. Forge Health reserves the right to remove or edit content at its sole discretion.
Links/Third Party Websites
Forge Health has not reviewed all the sites linked to the Website and is not responsible for the content or any off-site pages or other linked sites. Although a third party website may contain the Forge Health logo, please understand that it is independent from Forge Health, and that Forge Health has no control over the content of that website. Going to third party or off-site websites from the Website is at your own risk. These links do not imply endorsement of, sponsorship of, or affiliation with Forge Health.
Intellectual Property Rights
The trademarks and trade dress of Forge Health are proprietary to Forge Health and may not be used by you for any reasons other than as expressly permitted by these terms. All Website content, design, text, graphics, and interfaces; the collection, selection, and arrangement thereof; and all software are property of, or duly licensed to, Forge Health. You have the right to view, electronically copy, and print in hard copy portions of the Website for the sole purpose of personal use.
Any other use of materials on the Website, including modification, distribution, or reproduction for purposes other than those noted above, without the prior written permission of Forge Health, is strictly prohibited.
You acknowledge that Forge Health and/or third party content providers remain the owners of all Website and materials, and that you do not acquire any of those ownership rights by downloading, copying, or using any such material in accordance with these Terms and Conditions. Forge Health may discontinue or remove the Website, or any portion thereof, or discontinue your right to use the Website, or any portion thereof, at any time.
NOT AUTHORIZED TO PERFORM DATA MINING
You are not authorized without the prior written permission of Forge Health to use any computer code, data mining software, “robot,” “bot,” “spider,” “scraper” or other automatic device, or program, algorithm or methodology having similar processes or functionality, or any manual process, to monitor or copy any of the web pages, data or content found on this Website or accessed through this Website. You also may not engage in the mass downloading of files from this Website; use the computer processing power of this Website for purposes other than those permitted above; flood this site with electronic traffic designed to slow or stop its operation; or establish links to or from other websites to this Website.
NOT AUTHORIZED TO USE THIS WEBSITE FOR COMMERCIAL PURPOSES
Users are not authorized to sell, reproduce, distribute, modify, display, publicly perform, report or otherwise prepare derivative or second hand works based on any Forge Health material in any way for any public or commercial purpose. Thus, you are not authorized to (i) resell or make commercial use of this site or its contents; or (ii) create, reproduce and/or distribute any materials derived from the content provided on this Website. Furthermore, Forge Health material may not be displayed or communicated on any other website and/or app, in a networked computer environment or other digital support for any purpose whatsoever. In the event of breach of any of these Terms and Conditions, User’s permission to use Forge Health material will automatically terminate and any copies made of Forge Health material must be immediately destroyed.
Any unauthorized use of Forge Health material may violate state and federal criminal laws, infringe copyright laws, trademark laws, the laws of privacy or publicity, and communication regulations and statutes.
Warranty Disclaimer and Limitation of Liability
In no event will Forge Health be liable for any direct, indirect, special, or other consequential damages resulting from your use of the Website, or on any other linked/third-party website, including without limitation, any lost profits, business interruption, loss of programs, or other data on your information handling systems or otherwise, including any claims waived by you previously in this agreement even if Forge Health has been expressly advised of the possibility of such damage.
All information is provided by Forge Health on an “as is” basis only. Forge Health provides no representations and warranties, express or implied, including the implied warranties of fitness for a particular purpose, merchantability, and non-infringement.
Choice of Law
The Website, and your use hereof, is governed by the laws of the State of New York, without regard to New York’s choice of law provisions. Any claim arising out of your use of this Website must be brought in New York.
Occasional changes may be made to this document as new services and content are added to the Website to reflect changes in Forge Health policies. The Terms and Conditions may be revised at any time by updating this posting. By using the Website, you agree to be bound by any such revisions. Users of the Website are encouraged to check this document periodically to stay informed of current privacy guidelines.
Acceptance of Terms
By using the Website, you signify your acceptance of the Terms and Conditions. If you do not agree to this, please refrain from using the Website. Your continued use of the Website following the posting of changes to these terms will indicate your acceptance of those changes.