Last Updated: January 15, 2025
This consent outlines the terms and conditions for healthcare services you, your caregiver, or other authorized individual, as applicable (collectively, “you”) receive from Rippl PC, the medical practices who work with Rippl: Rippl Care PC of Washington, Inc., Rippl Care PC of California, Inc., Rippl Care PC of Kansas, P.A., Rippl Care PC of New Jersey, P.C., and WB Medical of NY, P.C. (collectively, “Rippl PC,” “we” or “us”).
If you have any questions, please don’t hesitate to contact us at [email protected].
- Updates to the Consent. We may update this consent without notice, but will update the “Last Updated” date at the beginning of the consent when we have made a material If you don’t agree with the changes, you can stop using Rippl PC’s services at any time.
- Your Financial Responsibility. You agree to pay for the services you receive from Rippl PC. We may bill your insurance and you are responsible for any unpaid When you provide us with information about your insurance, that will be considered authorization for us to submit claims for healthcare services to your health insurance plan.
- Permission to Treat. You give Rippl PC permission to provide healthcare services to you. This may include prescribing medication and informing you of potential side If your state requires it, we may ask you to complete a separate psychotropic medication consent form.
- Service Termination. You can stop using Rippl PC’s healthcare services at any time, and we can stop providing healthcare services to you at any time. If we can no longer provide healthcare services to you, we will make every effort to contact you, and help you transfer your records to your new healthcare provider.
- Notice of Privacy Practices. You acknowledge receipt of our Notice of Privacy Practices, which describes how we may use and disclose your health information. A copy can also be obtained on our website, or we will send you a paper copy upon request.
- Consent to Electronic Communications. You agree that we may contact you via messaging, email, phone, text, or mail. Those communications may be through our website, app, or otherwise, including electronic communications about your healthcare which may include protected health information (PHI). You understand that communicating via email, text messages, and other electronic means may not be secure, and could be viewed by unintended persons, and you agree to communicate with us via these electronic means. You agree to update your contact information as needed to ensure accuracy in our communications to you. You can opt out of communications from Rippl PC at any time. You agree not to record any audio or visual communication with Rippl PC, including any Telehealth Services, without the express written consent of all parties to the relevant communication.
- Limitation of Liability. Telehealth services may have limitations. Except in cases of gross negligence or willful misconduct, Rippl PC is not liable for any harm related to your use of our clinical services.
- Telehealth Services Consent. Telehealth Services are healthcare services delivered remotely using technology. This can include video calls, telephone consultations, or secure messaging to connect with Rippl PC health care providers. You understand that there are risks and limitations in using telehealth, and that telehealth may not be appropriate for all conditions. If you are experiencing a medical emergency, please do not use the telehealth services, and dial 911 or otherwise seek emergency medical treatment immediately.
- Consent to Record for Training of Artificial Intelligence (AI) Tools and Healthcare Operations. We may use artificial intelligence (“AI”) tools to assist in our healthcare operations, and may use your personal information to train AI tools. We may also record and process your personal details while using our telehealth services to improve our healthcare services.
- Dispute Resolution. If there is a dispute between you and Rippl PC, the dispute will be resolved through individual arbitration. The details of that dispute resolution process are in the Agreement to Arbitrate in the Terms of Service on our website, as may be modified from time to time, and is hereby incorporated into this Agreement.
- Notices:Open Payments Notice. For informational purposes only, a link to the federal Centers for Medicare & Medicaid Services (CMS) Open Payments web page is provided below. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public. The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov.
Notice to Florida Patients. Our care teams include a range of Rippl Care PC Clinicians, including physicians, advanced practice nurses, physician assistants, clinical social workers, care navigators, and other practitioners. You can notify us about any preferences regarding the makeup of your care team by sending an email to [email protected].
Notice to Texas Patients. Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, including physician assistants, may be reported for investigation at the following address: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Assistance in filing a complaint is available by calling the following telephone number: 1-800-201-9353, For more information, please visit website at www.tmb.state.tx.us. Las quejas sobre médicos, asi como sobre otros profesionales acreditados e inscritos del Consejo Médico de Tejas, incluyendo asistentes de médicos, practicantes de acupuntura y asistentes de cirugia, se pueden presentar en la siguiente dirección para ser investigadas: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Si necesita ayuda para presentar una queja, llame al: 1-800-201-9353, Para obtener más información, visite sitio web en www.tmb.state.tx.us.
