Effective Date: 11/13/2024
DO NOT USE THE SERVICES IF YOU HAVE A MEDICAL EMERGENCY. IF YOU ARE HAVING A MEDICAL EMERGENCY, PLEASE DIAL 911 OR GO IMMEDIATELY TO THE EMERGENCY ROOM.
This Telehealth Consent and Terms of Care (these “Terms”) is a contract between you and one or more of the following entities based on the state of your primary residence and/or your physical location during treatment: Gritwell Medical, P.C. (for users in California) and Gritwell medical TX, P.A. (for users in Texas) (collectively, “Gritwell Medical Group,” “we,” “our,” or “us”). Gritwell Medical Group provides virtual root cause and functional medicine services (the “Services”) through healthcare providers who are licensed in accordance with applicable state laws, rules, and regulations (“Providers”). These Terms govern your use of the Services.
Please read these Terms carefully. By clicking “I accept”, “I agree,” or similar when the option is presented to you, or by accessing or using the Services, you acknowledge that you have read, understand, and agree to these Terms and consent to receives Services from Gritwell Medical Group. If you do not agree to these Terms, you are not allowed to use the Services.
While there are important provisions throughout these Terms, please note the following:
CONSENT TO CARE AND TELEHEALTH CONSENT: You consent to treatment and telehealth services in Section 2.
CONSENT TO USE AND DISCLOSE HEALTH INFORMATION: You consent to Gritwell Medical Group’s use and disclosure of your health information as described in Section 4.
WARRANTY DISCLAIMERS AND LIABILITY LIMITATIONS: The disclaimers and limitations on our liability are explained in Section 5.
MANDATORY ARBITRATION NOTICE: Section 6 contains a mandatory arbitration provision that requires the use of arbitration on an individual basis to resolve disputes. This means that you and Gritwell Medical Group are each giving up rights to bring claims against each other in court or in class actions of any kind.
Relationship between Gritwell Medical Group and Gritwell, Inc. Gritwell Medical Group works closely with Gritwell, Inc., a technology company that provides technological and administrative support to Gritwell Medical Group and owns and operates the Gritwell website and platform (the “Platform”). You acknowledge and agree that your access to and use of the Platform is subject to the Gritwell, Inc. Terms of Use. Gritwell, Inc. is not a healthcare provider and does not provide medical services or medical advice.
Location and Eligibility for Services. You must be at least 18 years old and are otherwise legally qualified to enter into and form contracts under applicable law to use the Services. You will be asked for your current state of residence when registering to use the Platform. You agree to notify us and updated your state of residence in the Platform if you move. You agree that you will only use the Services while located in your state of residence. We may ask you to verify your state of residence and/or physical location to ensure compliance with applicable law relating to the licensure of our Providers. You acknowledge that you may not be able to access the Services without providing us with your physical location. We reserve the right to refuse to provide Services to you if you are in a jurisdiction that we do not serve.
Consent to Care. You consent to diagnosis, medical care and treatment that you have agreed to receive and that is considered necessary or recommended by your Providers, including treatment and services through the use of telehealth technologies. You acknowledge and agree that no guarantees have been made to you about the result of your examination, care, or treatment.
Consent to Telehealth Services. "Telehealth Services" means the delivery of Services using technology when you and your Provider are not in the same physical location, and/or the virtual delivery of healthcare services, including by a Provider or via digital or automated tools, including without limitation tools for medical or health-related diagnosis and treatment.
The Telehealth Services may be used for diagnosis, treatment, care, follow-up and/or patient education, and include the following: electronic transmission of patient medical records, medical images, and/or other patient data or information; synchronous (i.e., "real time") and asynchronous (i.e., non-"real time") interactions via audio, video, text, and/or data or other electronic communications; automated, electronic or digital tools or services for diagnosis, care, treatment and/or communication pertaining to healthcare or medical matters; and output, transmission or exchange of data from medical devices, sound and video files.
You acknowledge and agree that:
Gritwell Medical Group provides Telehealth Services that are not intended as a substitute for routine or ongoing medical care or advice for acute or chronic conditions or illnesses.
You will be assigned to a Provider licensed to provide Services in your state prior to the consult.
You are prohibited from recording or taking pictures of your interactions with a Provider or other care team member without your Provider’s and Gritwell Medical Group’s prior written consent.
There are various benefits associated with Telehealth Services, including improved access to care by enabling you to remain in your home while the Provider consults with you, more efficient care evaluation and management, and obtaining expertise of a specialist located some distance away.
Possible risks to Telehealth Services include delays in evaluation and treatment due to deficiencies or failures of the equipment and technologies.
You are responsible for providing accurate medical information to your Provider. It is up to your Provider to determine whether your specific needs are appropriate for Telehealth Services.
Telehealth Services using video conferencing technology and messaging-based communications will not be the same as a direct client/therapist visit because you will not be in the same room as your therapist. Alternatives to Telehealth Services, such as in-person services, are available to you.
Information transmitted through the Telehealth Services may not be sufficient quality to allow for appropriate medical decision making, thus necessitating a rescheduled telehealth encounter or a meeting with your local healthcare provider.
You or your Provider may discontinue any Telehealth Services encounter if you or the Provider determine that the telehealth technology used for the encounter is not adequate for the situation.
You will not be prescribed any controlled substances and we do not guarantee that you will receive a prescription at all.
You may withhold or withdraw your consent to the use of Telehealth Services in the course of your care at any time. However, if you withdraw your consent, we will not be able to provide Services to you.
The state in which you reside or are located at the time you use the Services may require us to provide additional notices to you or obtain additional consents from you regarding the Telehealth Services. You can review the additional disclosures and consents applicable to you, if any, here . These disclosures and consents are incorporated into these Terms.
Your Financial Responsibility. No Insurance Accepted. You agree that you are solely responsible for the costs of any services or products provided to you. We do not accept commercial health insurance plans, are not in-network with any commercial health insurance plans and are not enrolled with federal or state healthcare programs, such as Medicare and Medicaid. By choosing to use the Services, you are specifically choosing to obtain products and services offered by the Providers on a cash-pay basis outside of any commercial health insurance plan or federal or state healthcare program. You agree that you will not submit a claim for reimbursement to any government healthcare program or commercial health insurance plan for the costs of the services and products provided to you through the Services. If you are covered by a government health plan, please consult with a provider who participates in such plans.
Subscriptions. The Services are offered on a subscription basis through the Platform, and you agree to pay all fees for the Services. For more information about your subscription and cancellation options, please review the Gritwell, Inc. Terms of Use
Excluded Services. Your subscription does not cover (i) any ancillary services; (ii) unless otherwise specified by us in writing, any services provided by third parties; (iii) hospital services, emergency room visits, or urgent care facility visits; (iv) appointments with other providers or specialists you are referred to (whether by Gritwell Medical Group or otherwise); or (v) any services not expressly listed as included in your applicable Subscription (collectively, the “Excluded Services”). Gritwell Medical Group is not responsible for any medical bills incurred for any Excluded Services, even if Gritwell Medical Group has referred you for such services.
Consent to Use and Disclose Health Information. You agree and consent to Gritwell Medical Group using, disclosing, and/or releasing your information, including your “sensitive health information”, as permitted by law for purposes of treatment, payment, or health care operations of Gritwell Medical Group, such as with your other health care providers in connection with your treatment, with Gritwell, Inc. or other contractors and/or affiliates of Gritwell Medical Group for scheduling, billing and other administrative purposes, with any person or entity liable for payment on your behalf in order to verify coverage or payment questions, or for any other purpose related to benefit coverage and payment. “Sensitive health information” includes information about psychiatric treatment, mental health or illness, or developmental or intellectual disability, substance use disorder treatment, and any other type of information that is given special privacy protection under state or federal laws.
Consent to Confidential Telephone and Electronic Communications. You authorize Gritwell Medical Group (and Gritwell, Inc. on behalf of Gritwell Medical Group) to send confidential communications, including calls, text messages, and emails, to the phone numbers and email addresses we have on file for you and to leave voice messages regarding your health information at such numbers. You further authorize Gritwell Medical Group to communicate with you through chat features available on the Platform. You acknowledge that the content of these communications may include, but is not limited to, health information, preventative care, treatment recommendations, outstanding balances, and requests from Gritwell Medical Group for user feedback as part of your relationship with us. You acknowledge that text messages and emails may be unencrypted and carry some risk that the information in the messages could be read by an unauthorized person, and that we cannot guarantee the security and confidentiality of the text, email, or other electronic messages that we send to you, and we are not responsible for any unauthorized access that occurs during or after the transmission of any text messages or emails to you.
The Services are intended for use only within certain states in the United States and its territories. We make no representation that the Services are appropriate or are available for use in states where we do not currently operate or outside the United States.
TO THE MAXIMUM EXTENT PERMITTED BY LAW, IN NO EVENT WILL GRITWELL MEDICAL GROUP, OUR AFFILIATES, AND OUR AND THEIR OFFICERS, DIRECTORS, EMPLOYEES, PROVIDERS OR AGENTS BE LIABLE FOR ANY CONSEQUENTIAL, EXEMPLARY, INCIDENTAL, SPECIAL, PUNITIVE, OR OTHER INDIRECT DAMAGES, INCLUDING WITHOUT LIMITATION THOSE RELATING TO LOST PROFITS OR THE COST OF SUBSTITUTE PRODUCTS OR SERVICES ARISING OUT OF OR IN CONNECTION WITH THE SERVICES OR YOUR USE OF OR INABILITY TO USE THE SERVICES, WHETHER BASED ON CONTRACT, WARRANTY, PRODUCT LIABILITY, TORT OR OTHER LEGAL THEORY AND EVEN IF WE HAVE BEEN INFORMED OF THE POSSIBILITY OF SUCH DAMAGES.
SOME JURISDICTIONS DO NOT ALLOW CERTAIN EXCLUSIONS OR LIMITATIONS OF LIABILITY, SO THE ABOVE EXCLUSIONS AND LIMITATIONS MAY NOT APPLY TO YOU.
Dispute Resolution and Arbitration Agreement
PLEASE READ THIS SECTION CAREFULLY BECAUSE IT REQUIRES YOU AND GRITWELL MEDICAL GROUP TO RESOLVE ALL DISPUTES BETWEEN US THROUGH BINDING INDIVIDUAL ARBITRATION AND LIMITS THE MANNER IN WHICH YOU CAN SEEK RELIEF FROM GRITWELL MEDICAL GROUP. YOU UNDERSTAND AND AGREE THAT, BY ENTERING INTO THESE TERMS, YOU AND GRITWELL MEDICAL GROUP ARE EACH WAIVING THE RIGHT TO A TRIAL BY JURY AND THE RIGHT TO PARTICIPATE IN A CLASS ACTION.
We want to address your concerns without needing a formal legal case, so we have included a tiered dispute resolution process. This Dispute Resolution section may be modified by written agreement between you and Gritwell Medical Group.
Informal Dispute Resolution. Before filing a claim against Gritwell Medical Group, you agree to try to resolve the dispute informally by contacting [email protected]. If a dispute is not resolved within thirty (30) days after submission, you may bring a formal proceeding, as outlined below.
AGREEMENT TO ARBITRATE
You agree that any disputes that you and we are unable to resolve informally will be settled by binding arbitration, except that you and we each retain the right to bring an individual action in small claims court. You will also have the right to litigate any other dispute if you provide us with written notice to opt out of arbitration (“Arbitration Opt-out Notice”) by email at [email protected] within thirty (30) days following the date you first accept these Terms, or if you have not registered for an account, then within thirty (30) days following the date you first use the Services. If you don’t provide us with an Arbitration Opt-out Notice within the thirty (30) day period, you will be deemed to have knowingly and intentionally waived your right to litigate any dispute except as expressly set forth above. If a decision is issued stating that applicable law precludes enforcement of any limitations set forth in this Agreement to Arbitrate on the right to arbitrate claims on a class or representative basis, or as part of a consolidated proceeding, as to a given claim for relief, then that claim (and only that claim) must be severed from the arbitration and brought in the state or federal courts located in the state of incorporation for the GritWell professional entity that provides Services to you. All other claims will be arbitrated.
Arbitration Rules. The arbitration will be administered by the American Arbitration Association (“AAA”) in accordance with the Commercial Arbitration Rules and the Supplementary Procedures for Consumer Related Disputes (the “AAA Rules”) then in effect, except as modified by this “Governing Law; Dispute Resolution; Arbitration” section. (The AAA Rules are available at https://www.adr.org/Rules.) The Federal Arbitration Act will govern the interpretation and enforcement of this Section.
Arbitration Process. A Party who desires to initiate arbitration must provide the other party with a written Demand for Arbitration as specified in the AAA Rules. AAA provides a general form for a Demand for Arbitration and a separate form for Demand for Arbitration for California residents. The arbitrator will be either a retired judge or an attorney licensed to practice law and will be selected by the parties from the AAA’s roster of arbitrators. If the parties are unable to agree upon an arbitrator within seven (7) days of delivery of the Demand for Arbitration, then the AAA will appoint the arbitrator in accordance with the AAA Rules.
Arbitration Location and Procedure. The Arbitration shall be held either: (i) at a location determined by AAA pursuant to the AAA Rules (provided that such location is reasonably convenient for you and does not require travel more than 100 miles from your home or place of business); (ii) at such other location as may be mutually agreed upon by you and us; or (iii) via videoconference. If your claim does not exceed $10,000, then the arbitration will be conducted solely based on the documents that are submitted to the arbitrator, unless you request a hearing or the arbitrator determines that a hearing is necessary. If your claim exceeds $10,000, your right to a hearing will be determined by the AAA Rules. Subject to the AAA Rules, the arbitrator will have the discretion to direct a reasonable exchange of information by the parties, consistent with the expedited nature of the arbitration.
Arbitrators Decision. The arbitrator will render an award within the time frame specified in the AAA Rules. The arbitrator’s decision will include the essential findings and conclusions upon which the arbitrator based the award. Judgment on the arbitration award may be entered in any court having jurisdiction thereof. The arbitrator’s award of damages must be consistent with the terms of the “Disclaimers and Limitation of Liability” section above as to the types and amounts of damages for which a party may be held liable. The arbitrator may award declaratory or injunctive relief only in favor of the claimant and only to the extent necessary to provide relief warranted by the claimant’s individual claim. If you prevail in arbitration, you will be entitled to an award of attorneys’ fees and expenses to the extent provided under applicable law.
Arbitration Location and Procedure. The Arbitration shall be held either: (i) at a location determined by AAA pursuant to the AAA Rules (provided that such location is reasonably convenient for you and does not require travel more than 100 miles from your home or place of business); (ii) at such other location as may be mutually agreed upon by you and us; or (iii) via videoconference. If your claim does not exceed $10,000, then the arbitration will be conducted solely based on the documents that are submitted to the arbitrator, unless you request a hearing or the arbitrator determines that a hearing is necessary. If your claim exceeds $10,000, your right to a hearing will be determined by the AAA Rules. Subject to the AAA Rules, the arbitrator will have the discretion to direct a reasonable exchange of information by the parties, consistent with the expedited nature of the arbitration.
Fees. Your responsibility to pay any AAA filing, administrative and arbitrator fees will be solely as set forth in the AAA Rules.
Changes. Notwithstanding anything to the contrary in these Terms, if we change this “Dispute Resolution” section after the date you accepted these Terms or access our Services, you may reject any such change by sending us written notice (including by email to [email protected]) within 30 days of the date such change became effective, as indicated in the “Last Updated” date listed at the beginning of these Terms or in the date of our email to you notifying you of such change. By rejecting any change, you are agreeing that you will arbitrate any dispute between you and us in accordance with the provisions of this “Dispute Resolution” section as of the date you accepted this these Terms or accessed our Services.
No Class Actions. YOU AND WE AGREE THAT EACH MAY BRING CLAIMS AGAINST THE OTHER ONLY IN YOUR OR ITS INDIVIDUAL CAPACITY AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING. Further, unless both you and we agree otherwise in writing, the arbitrator may not consolidate more than one person's claims and may not otherwise preside over any form of a representative or class proceeding.
Miscellaneous Terms
Entire Agreement. These Terms are the entire and exclusive understanding and agreement between Gritwell Medical Group and you regarding the Services and other subject matter herein, and supersedes and replaces all previous communications, representations, understandings, and agreements, either oral or written, between the parties with respect to said subject matter, excluding any other agreements that you may have entered into with Gritwell Medical Group.
Governing Law. These Terms shall be governed by the laws of the State of Delaware without reference to its conflict of laws provisions.
Severability. If any provision of these Terms are determined to be invalid, illegal, or unenforceable, the remaining provisions of these Terms remain in full force, provided that the essential terms and conditions remain valid, binding, and enforceable and the economic and legal substance of the transactions contemplated by these Terms are materially preserved.
Survival. Any provision of these Terms that by its nature should survive termination will survive such termination.
Contact Us. If you have any questions about these Terms and/or any other documents referenced in these Terms, please feel free to contact us at [email protected].
Texas: You understand that your medical records may be sent to your primary care physician. (Tex. Occ. Code Ann. § 111.005). You have been informed of the following notice:
NOTICE CONCERNING COMPLAINTS -Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, including physician assistants, acupuncturists, and surgical 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 our website at www.tmb.state.tx.us.
AVISO SOBRE LAS QUEJAS- 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 nuestro sitio web en www.tmb.state.tx.us
149 New Montgomery Street,
San Francisco, CA 94103
