Terms are subject to change at any time

By scheduling services with Resonate Health, Inc., you agree to the following:

Resonate Health Inc. is dedicated to maintaining the privacy of your individually identifiable health information (also called protected health information, or PHI).  In conducting our business, we will create records regarding you and the treatment and services we provide to you.  We are required by law to maintain the confidentiality of health information that identifies you.  We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your PHI.  By federal and state law, we must follow the terms of the Notice of Privacy Practices that we have in effect at the time. 

Your record will be kept confidential and will NOT be released to others unless required by law or specifically directed by you or your legal representative.Your record MAY be shared in the following ways:

• We may use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your protected health information may be provided to a health care provider to whom you have been referred to ensure the necessary information is accessible to diagnose or treat you.
• With family, friends, relatives, or others that you specifically identified on this form as having access to your health information or treatment.
• With other clinic members, administrative staff, or students under their tutelage, who are involved in your treatment. Information will only be shared on a need-to-know basis.
• For general healthcare operations; We may use or disclose, as needed, your protected health information in order to support the business activities of the organization.
• Your protected health information may be used to bill or obtain payment for your health care services.
• To protect the public’s health, such as reporting when the flu is in the area.
• To make required reports to the police, such as gunshot wounds.
• Your provider is also required to report suspected abuse of an elder or child.

ACCESSING YOUR MEDICAL RECORDS
You may look at your health record or request a copy at any time in writing; it can take up to 30 days for us to deliver your records. You have the right to make requests on how and with whom your information is shared.

In consideration of being allowed to participate in services at Resonate Health, Inc., I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the event’s leader, organizers, hosts and participants from any and all liability, claims, demands, or course of action whatsoever arising out of, or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me whether caused by the negligence of release, or otherwise, while participating in this event, or while in, on or upon the premises where the event is being conducted. 

To the best of my knowledge, I am in good physical condition and I am not aware of any physical and physiological infirmity, which would place me at risk to participate in any way with the wellness activities. I am fully aware of the risks and hazards connected with this event. I also fully understand that event’s leaders and organizers may advise on common contraindications that can create additional risk with this work but are not liable as it relates to my existing health conditions. 

I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISK OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or any loss or damage to property owned by me as a result of being engaged in the event’s activities whether caused by the negligence of release, or otherwise. 

I acknowledge it is my responsibility to know and understand the laws where I live, and follow them accordingly.  

I understand that this is a consultation for the purpose of helping me improve my health and wellness.  I understand that this does not include medical diagnosis or treatment and is not a substitution for medical care or an agreement for ongoing care. 

I acknowledge and represent that I have read this waiver voluntarily and understand its contents; I am an adult, of at least nineteen years of age or older, and fully competent; and I execute this Release for full, adequate and complete considerations fully intending to be bound by same. This waiver applies to all present and future work with this event’s leaders and organizers.

Resonate Health and its associated providers are not contracted (or in-network) with any insurance plans and will not communicate with insurance companies on any patient’s behalf.  We do not provide insurance billing documents (superbills) to patients, nor do we provide CPT or ICD-10 codes for reimbursement purposes.  All payment will be collected at the time of booking and prior to rendering of services.  

We reserve the right to terminate the provider/patient relationship at any time for any reason, and are under no obligation to state the reason for discontinuing care.

Refunds will not be provided for missed appointments. Reschedule and cancellation requests must be made within 24 business hours of the original scheduled visit. 

We ask for all patients to be on time for their scheduled visit, we do understand that unforeseen circumstances can at times result in late arrival.  As a courtesy to other patients and to the provider, we will end your appointment at the scheduled time if you arrive late (for example, If your appointment was scheduled from 9:00 to 10:00 am and you arrive at 9:10 am, the visit will still end at 10:00am). You will still be charged for a full visit, and may be required to make another appointment to finish whatever wasn’t covered in your truncated session.

If you are more than 15 minutes late for your appointment, we reserve the right to cancel your appointment without refund.  

The preferred method of communication at Resonate Health is via our secure patient portal; we request all communications to be carried out via the patient portal.  Communications received via text or email are not secure and may result in a delayed response time.  Any and all communications will be responded to within 24 to 48 business hours. There is no on-call or emergency communication service at Resonate Health.  In the event of a medical emergency, please contact your primary care physician or local emergency number (911, etc.).

Simple inquiries made outside of scheduled appointment times will be addressed free of charge.  Any inquiry related to treatment changes, new symptoms or complaints, or anything requiring greater than 5 minutes of your provider’s time will incur a fee and we may require payment or request for you to schedule a billable visit.