Care Recipient Authorization
Palm Care, Inc. (dba. “Care Hero, “we”, “us”, “our”) provides online products and services(collectively, the “Services”) through our mobile applications and gocarehero.com (collectively, the “Site”) that may, among other things, provide tools to engage in supportive care management for persons that require care assistance (for chronic illnesses and other situations). Our Site and Services allow your caregiver to establish a care team(“Care Circle”) of persons interested in your health and well-being for the purpose of providing care management services (e.g., transportation and meal services) to you.
This authorization is optional. By agreeing, you authorize Care Hero to use and disclose your Health Information that we receive through the Site and Services so that we can provide you and your care circle Services. By “Health Information” we mean protected health information as that term is defined by the privacy rule under the HealthInsurance Portability and Accountability Act of 1996 (“HIPAA”). HIPAA's privacy rule defines this term as identifiable information about (a) your physical or mental health or condition; (b) the provision of health care to you; and (c)payment for the provision of health care to you. Protected health information may include information that is created both before and after the date of this authorization.
The Health Information we and members of your care team(“Care Circle”) may use and disclose includes: your name, address, medical condition, health care providers' names and addresses.
We may use and disclose this Information for the following purposes:
Disclosure of your Health Information to members of your care team(“Care Circle”), so they can support you;
Disclosure of your Health Information to third persons for purposes of providing support services, such as rides and meals, to you;
Disclosure of your Health Information if required by law or where we deem necessary for our legal compliance and defense; and
Use and disclosure of your Health Information for purpose of the proper operation and management of our business.
Classes of persons or entities to whom your Health Information may be disclosed includes, without limitation: Care Hero and its vendors providing services to you, members of your care team(“Care Circle”), and governmental authorities.
By agreeing to this authorization, you understand and agree:
Care Hero will not condition your treatment, payment, enrollment, or eligibility for benefits on whether you agree to this authorization. However, if you do not provide this Authorization, we cannot provide the Services to you and your care team(“Care Circle”).
All HIPAA authorizations are required by law to inform you that your health information that is disclosed under this authorization may be re-disclosed by the recipient and no longer protected by federal privacy regulations.
You may receive a copy of this authorization if you ask for it in writing addressed to Care Hero's Operation Team at this address: 125 Western Ave., Batten Hall, MA 02134.
This authorization will expire upon the deactivation of all of your accounts for Services. You may revoke this authorization at any time by notifying Care Hero's Operation Team in writing at the address above. Revoking this authorization will not affect any actions that Care Hero or any recipient of a disclosure took in reliance on the authorization before receiving your revocation.
We encrypt and store data securely.
We only share information for the purpose of providing certain benefits at your request (on behalf of the care recipient when applicable).
If your employer is an Care Hero partner unlocking additional benefits for you, your employer cannot see your personal data.
