Authorization to Use and Disclose Health Information

Authorization to Use and Disclose Health Information

You agree that as part of your use of the ZibdyHealth website (“Site”) and ZibdyHealth Services, including the ZibdyHealth Mobile Applications and social network Applications (“Services”), Zibdy, Inc. (“ZibdyHealth” or “Zibdy”) may use and disclose your health information, including information that may personally identify you (“Personal Health Information”), as described in this Authorization to Use and Disclose Health Information (“Authorization”).

Specifically, by clicking the “I Consent” button below, you authorize ZibdyHealth to use and disclose your Personal Health Information to the following persons or entities for the following purposes:

• To the family members, friends or caregivers who you authorize as secondary users of your ZibdyHealth account.  ZibdyHealth may share your Personal Health Information with these persons so that they can help you obtain ZibdyHealth’s services and manage your account, manage your health and wellness, and to obtain care and advice from healthcare providers.

• To the family members you select using the personal settings of you ZibdyHealth account.  ZibdyHealth may share the Personal Health Information you select, with the family members you select, so that those family members can use it in obtaining ZibdyHealth’s services, to manage their own health and wellness, and to obtain care and advice from their healthcare providers.

• To none of your family members according to the default settings on your account.  You understand that the default settings of your account won’t permit ZibdyHealth to share your information with family members.

• To the healthcare providers, pharmacists and pharmacies you select using the personal settings of your ZibdyHealth account.  ZibdyHealth may share your Personal Health Information with the healthcare providers, pharmacists and pharmacies you select for their use in diagnosis or treatment (including direct or indirect treatment by other healthcare providers involved in your treatment and the provision of medication), obtaining payment from third party payers, and in their health care operations.

• To ZibdyHealth for ZibdyHealth to use in providing you the ZibdyHealth Services.  ZibdyHealth may use your Personal Health Information as described in the ZibdyHealth Privacy Policy.  Specifically, ZibdyHealth may use your Personal Health Information to provide you with information ZibdyHealth believes may be of interest to you, including, but not limited to:  to provide you notifications regarding your medications, appointments or condition; to provide you other health information or information about other medications that might interest you; to provide you information you may wish to know about your possible health conditions given the medical histories of members of your family; or for marketing to you products or services you may be interested in.  You understand this list is not exhaustive, and that ZibdyHealth may use your Personal Health Information to provide you with other information not listed here that Zibdy, in its sole discretion, believes will be of interest or use to you.  ZibdyHealth may also use your Personal Health Information for internal purposes such as to improve the ZibdyHealth Site and ZibdyHealth Services, to notify you of new products or Services, and to otherwise communicate with you about ZibdyHealth.

• To other ZibdyHealth Applications.  ZibdyHealth may send your Personal Health Information to the specific other ZibdyHealth Applications that you select through your ZibdyHealth account for the uses described by those Applications.

• To other third-parties you select to receive your Personal Health Information.  You may specify additional third-parties to whom ZibdyHealth may share your Personal Health Information for the purposes you specify at the time you select them, including for purposes of diagnosis or treatment, payment, or the third-parties’ health care operations.

ZibdyHealth is not responsible for the manner in which third parties, including healthcare providers, use or disclose your Personal Health Information.  You should review the privacy policies of any healthcare providers or other third parties to whom you allow such information to be provided.

This Authorization applies to any of your Personal Health Information, including by not limited to individually identifiable health information and medical records regarding any past, present, or future medical or mental health condition, including, but not limited to, any and all information relating to the diagnosis and treatment of sexually transmitted diseases, mental illness (including information protected under California’s Lanterman-Petris-Short Act), HIV/AIDS, drug or alcohol abuse, and genetic testing information.

This Authorization will expire when you close, suspend or cancel your ZibdyHealth account.  Please see the section titled “Closing Your Account” in the ZibdyHealth Privacy Policy.  However, it may take some time for the closure of your account to become effective, and during that time information may continue to be used or disclosed as specified in this Authorization.

You understand that you may cancel this Authorization at any time. However, if you cancel this Authorization, you will no longer be able to use the ZibdyHealth Services.  You can cancel this Authorization in two ways. You can send an e-mail to ZibdyHealth at support@zibdy.com, with the subject line “Cancel Authorization re Health Information.”  If you cancel this Authorization, information that was already collected and disclosed about you may continue to be used in the manner you had previously authorized.

You should print and retain a copy of this Authorization for your records.  You have the right to receive a copy of this Authorization.  To receive a copy, please email support@zibdy.com, with the subject line “Request for Copy of Authorization.”

By clicking the “I Consent” button, you agree to the use and release of your Personal Health Information as described in this Authorization.