Zocdoc, Inc. (“Zocdoc“) works with your healthcare provider (“Provider“) to deliver a streamlined booking and appointment experience. As a part of this experience, Zocdoc provides services to your Provider which enable the Provider to securely receive and view information pertinent to delivering your care.
Certain information you share with your Provider may be classified as protected health information (“PHI“), and as such be protected under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA“). HIPAA places restrictions on the use and disclosure of PHI by both Providers (who are “Covered Entities“ as defined under HIPAA) and the companies, like Zocdoc, that perform certain services on their behalf (defined as “Business Associates“ under HIPAA). If you have a Zocdoc user account, you may also provide Zocdoc with certain personal information that is not subject to HIPAA (“Non-PHI“), the use of which is instead governed by Zocdoc's Privacy Policy.
The purpose of this HIPAA authorization (“Authorization“) is for you to give Zocdoc permission to use and disclose your PHI in the same way that we use and disclose your Non-PHI. With your authorization, Zocdoc will use your PHI as we would Non-PHI pursuant to the terms in our Privacy Policy, which may include redisclosing it to other third-parties. While all such third-parties contractually agree to protect the security of your information, such redisclosed information would not be subject to HIPAA, and Zocdoc cannot guarantee that these third-parties will not use your information in ways we did not intend or permit. Importantly, this Authorization is not required in order to receive treatment from any Provider, nor will your decision not to agree to this Authorization impact any use of Zocdoc's services that do not depend on such Authorization for their functionality.
If you give us this permission, we may use your PHI to serve your account in ways we could not otherwise. This may include to:
By signing, checking the corresponding box, or otherwise affirmatively assenting to this Authorization, you are authorizing the use and disclosure of your PHI as outlined above. Further, you represent that you have the authority to agree to this Authorization, either as the individual user for whom this form is intended or as the personal representative of such user.
This Authorization will remain valid unless and until it is revoked by you or you delete your Zocdoc account. You may revoke this Authorization at any time in the Permissions or Privacy tab on the Settings page of your marketplace account. Any revocation of this Authorization will only extend to PHI that has not already been used or disclosed pursuant to the terms herein.