Medical MemoryTM

Agreement with THEMEDICALMEMORY, LLC

Welcome to Medical MemoryTM (MM). This document explains how MM works, MM’s obligations and responsibilities, as well as your obligations and responsibilities as a MM account holder. This Agreement establishes the terms of the relationship between you and MM.

How MM Works.

After you have set up a MM account, your physician may record a visit with you using a camcorder, tablet, or other video-recording device. After the recording is completed, your physician or your physician’s designee (someone the physician asks to do this) at your physician’s sole discretion will transfer (called uploading) a copy of the video of your visit to a secure website (secure.themedicalmemory.com). Your video may be temporarily stored on your physician’s video-recording device or computer, but the video will be automatically deleted from this storage device after uploading your video to the MM website. When your video is uploaded, your video(s) will then be available for you and your physician to review. You will be sent a secure link via email for access to the MM site so you can then securely view your video online. You can also let others view your videos by securely sharing a link to them via email from the MM website. However, please note that videos contain your confidential personal health information and were created for your educational purposes only. Therefore, you should use appropriate discretion when deciding with whom to share your videos.

************************************************** By signing this Agreement, I agree to the following:

Consent to Creation of and Temporary Storage of Videos on MM Video Recordings and Storage Devices and MM Website.
My physician may record his or her conversations with me, including discussion of my confidential personal health information relating to my medical condition, diagnosis and treatment. My physician (or my physician’s designee) has my consent to upload the recorded videos to my secure private account on secure.themedicalmemory.com. I have the right to request, in writing or on camera, that my physician does not record or upload a particular visit to www.themedicalmemory.com.

My recorded video is stored for viewing on a computer server which provides online viewing via a secure connection. While MM employs industry standard practices to ensure the privacy of these videos (use of an encrypted connection, individual account names and passwords, secure server access), the privacy of my confidential personal health information on my videos cannot be guaranteed, and it is not protected by federal privacy laws and regulations such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

There are potentially serious security issues with any computer connected to the Internet without the appropriate protection, ranging from viruses, worms and other programs that can damage the user’s computer, to attacks on the computer by unauthorized or unwanted third parties. By using this service, I acknowledge and knowingly accept the potentially serious risks of accessing the Internet over an unsecured network. I acknowledge that it is recommended

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that users take steps to protect their own computer system, such as installing current anti-virus software and maintaining appropriate firewall protection.

MM approved employees may also view the videos in whole or part on the physician’s video- recording device or computer if it is necessary for routine maintenance of the MM website, to improve MM services, to preserve my videos, for quality assurance, and training purposes. MM will follow the Privacy Policy posted on its website, and MM will not share access to my videos without my consent, unless MM is required to do so by law.

I understand that this consent automatically expires one year after my MM account is canceled. If I want to cancel this consent before then, I will contact MM at email info@themedicalmemory.com or 1-855-667-4000.

Password Protection and Account Access. When I create my MM account, I will create a password to access my account and the videos stored in my account. I understand that to be secure, this password should contain at least one number and one symbol, and should not be easy for others to figure out. (For example, I should not use my name, my children’s names, or my birth date.)

Videos Are Not Part of My Medical Record. I understand that the videos recorded, copied and uploaded to the MM website are not created or maintained for the purposes of diagnosis or treatment, and are not therefore part of my medical record. These videos are created for my personal educational use and to help me recall and better understand the recorded discussion between my physician and myself.

MM videos may or may not include all aspects of my physician visit. Furthermore, procedure explanations, diagnoses, medications, treatment, and follow-up instructions discussed by my physician on a video may change after the video is recorded.

I understand and acknowledge that these videos may not be posted, transferred, forwarded, uploaded, sold, licensed or otherwise used for any purpose other than my personal educational use without the prior written consent of MM. Tampering with, recording on my computer via computer programs or other video recording devices, and any other misuses of those videos are prohibited. I understand and acknowledge that I don’t own the videos, but rather I only have access to the video through the MM website. MM owns all content and physical memory to store the videos. Provided, however, if my physician and I both consent in writing by signing a separate “MM Community” viewing consent, my video may be uploaded for sharing and viewing by other members of the “MM Community”.

Exclusions of Warranties, Disclaimer, Waiver of Liability and Indemnity. I have access to and are using the MM website on an “As Is” basis with all risk inherent in such access. MM is provided on an “as available” basis without warranties of any kind, either expressed or implied. There are NO IMPLIED WARRANTIES OF ANY KIND, INCLUDING MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. No advice or information given by MM shall create such a

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warranty. Under no circumstances shall MM be liable for any direct, indirect, incidental, special, punitive or consequential damages that result in any way for your use of or inability to use MM or to access the internet or any part thereof, or my reliance on or use of MM that result from mistakes, omissions, interruptions, deletion of files, errors, defects, delays in operation, or transmission, or any failure of performance. I also agree to indemnify and hold harmless MM from any claim, liability, loss, damage, cost, or expense arising out of or related to my use of the videos, or any loss of privacy due to a breach of security of the MM website or computer systems. MM is not responsible for material recorded by any end user.

Other Miscellaneous Legal Items. MM owns all proprietary and intellectual property rights to the MM website and the MM system, including trade names, trademarks, service marks, brand names, domain names, goodwill, logos, and my videos, and gives me a personal and revocable license to use MM when I set up an account. MM in its sole discretion or at the request of physician may suspend or terminate my license or access to my videos and cancel my account to use MM and view my videos at any time.

Time Limit on Access to Videos. I understand and acknowledge that the current MM policy is to store (archive in a digital library) all videos for 7 years. After seven (7) years from the date of the video, my videos will be permanently erased or destroyed.

Marketing. MM may collect and store my personal information for the purposes of marketing new or additional services to me including online advertising. My email address may be used to contact me regarding any such services.

Cancellation. This Agreement may be canceled at any time by contacting email info@themedicalmemory.com.

Amendment to Agreement. MM reserves the right to revise and amend the terms of this Agreement at any time and without notice. Following any amendment, MM will make available, and if I do not agree to the changes I can cancel my MM account. If I continue to use my MM account, it will constitute my consent and acceptance of such amended terms of the Agreement.

Governing Law. This Agreement is governed by the laws of the State of Arizona.
Disclosure of Financial Interest. I understand that my physician may have a financial interest in

MM and/or as a part of a licensing agreement, may receive a fee for each video uploaded.

Signature. I understand that I am not required to sign this Agreement. If I do not sign this Agreement, it will not affect my treatment or payment, enrollment or eligibility for insurance benefits. This is a voluntary service to create another method of communication between my physicians and me.

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