Jiguar offers services, such as helping you track developmental milestone for Age range between from newborn to 18 years of age. Jiguar helps you to find and learn about nearby healthcare providers, booking appointments for in office visits or online consultation with the healthcare provider(s) of your choice (each, “Your Healthcare Provider”) and managing and forwarding your health history forms and other health-related information to share with Your Healthcare Providers (“Jiguar Services”). As part of providing the Jiguar Services, Jiguar may collect, use, share, and exchange your health history forms and other health-related information with Your Healthcare Providers. Under a federal law called the Health Insurance Portability and Accountability Act (“HIPAA”), health and health-related information may be considered “protected health information” or “PHI” if such information is received from or on behalf of Your Healthcare Providers.
Safeguards for PHI
HIPAA protects the privacy and security of your PHI by limiting the uses and disclosures of PHI by most healthcare providers and by health plans (called “Covered Entities”) as well as companies, like Jiguar, that provide certain types of assistance to Covered Entities (called “Business Associates”). Under certain circumstances described in HIPAA, an individual need to sign an Authorization form before a Covered Entity, like Your Healthcare Provider(s), can disclose protected health information to a third party.
Non-Protected Health Information
Your PHI Authorization
The purpose of this Jiguar Authorization (“Authorization”) is to request your written permission to allow Jiguar to use and disclose your PHI in the same way as we use and disclose your Non-PHI. If Jiguar is a Business Associate of Your Healthcare Providers, Jiguar needs your Authorization to be able to use and disclose your PHI in the same way it can currently use and disclose your Non-PHI when Jiguar is not working on behalf of Your Healthcare Providers, but is instead working on its own behalf. Therefore, when Jiguar relies on this Authorization, and uses and discloses PHI as described in this Authorization, it is not working as a Business Associate and the HIPAA requirements that apply to Business Associates will not apply to such uses and disclosures.
If you e-sign this Authorization, you give your permission to Jiguar to retain your PHI and to use and/or disclose your PHI in the same way that you have agreed that your Non-PHI can be used and disclosed.
Specifically, you agree that Jiguar can use your PHI to:
- Enable and customize your use of the Jiguar Services.
- Share information with your healthcare provider to better assist you with diagnosis and treatment
- Provide you alerts or other Jiguar Services regarding Current and future appointments.
- Provide you with updates and information about a provider when a timeslot becomes available
- Market to you about Jiguar and third-party products and services.
- Conduct analysis for Jiguar’s business purposes.
- Support development of the Jiguar Services; and
- Create de-identified information and then use and disclose this information in any way permitted by law, including to third parties in connection with their commercial and marketing efforts.
You also agree that Jiguar can disclose your PHI to:
- Third parties assisting Jiguar with any of the uses described above.
- Your Healthcare Providers to enable them to refer you to, and make appointments with, other providers on your behalf, or to perform an analysis on potential health issues or treatments, provided that you choose to use the applicable Jiguar Service;
- A third party as part of a potential merger, sale or acquisition of Jiguar.
- Our business partners who assist us by performing core services (such as hosting, billing, fulfilment, or data storage and security) related to the operation or provision of our services, even when Jiguar is no longer working on behalf of Your Healthcare Providers;
- A provider of medical services, in the event of an emergency; and
- organizations that collect, aggregate, and organize your information so they can make it more easily accessible to your providers.
The patients PHI may contain information about physical, sexual or drug abuse history. It may also contain history of mental illness or STD or HIV. By signing this form the parent/guardian given consent to release this information to the health care provider within the Jiguar network, the parent chooses to consult.
If Jiguar discloses your PHI, Jiguar will require that the person or entity receiving your PHI agrees to only use and disclose your PHI to carry out its specific business obligations to Jiguar or for the permitted purpose of the disclosure (as described above) Jiguar cannot, however, guarantee that any such person or entity to which Jiguar discloses your PHI or other information will not re-disclose it in ways that you or we did not intend or permit.
Expiration and Revocation of Authorization
Your Authorization remains in effect until you provide written notice of revocation to Jiguar.
YOU CAN CHANGE YOUR MIND AND REVOKE THIS AUTHORIZATION AT ANY TIME AND FOR ANY (OR NO) REASON.
If you wish to revoke this Authorization, you must notify Jiguar by submitting a revocation through your account settings page. Your decision not to execute this Authorization or to revoke it at any time will not affect your ability to use certain of the Jiguar Services. A Revocation of Authorization is effective after you submit it to Jiguar, but it does not have any effect on Jiguar’s prior actions taken in reliance on the Authorization before revoked.
Once Jiguar receives your Revocation of Authorization, Jiguar can only use and disclose your PHI as permitted in Jiguar’s agreements with Your Healthcare Provider(s). Your Revocation of Authorization does not affect Jiguar’s use of your Non-PHI.
We will make available to Your Healthcare Provider(s), current and past, your agreement to or revocation of this Authorization.