** Master HIPAA Terms and Conditions extracted from Terms of Use Agreement, Effective Date: August 5, 2021

Authorization to Share Your Data.

This Section is applicable to you if you are an individual that uses or discloses your individually identifiable Protected Health Information (defined below) through the use of the Service. By accepting these Terms, you authorize Vacmobile to disclose your Data (which may include your individually identifiable protected health information, name, date of birth, vaccine information, lot number for vaccine, date of service ) to those entities and individuals (i) you identify on your account profile, (ii) to whom you provide your unique access number and/or electronic invitation for the purposes of accessing your account (if applicable), (iii) you otherwise designate by notifying Vacmobile; (iv) Designated Entity(ies) that You provide (v) your healthcare provider; (vi) as permitted by these Terms; or (ix) as required by law. Your Data means any and all data that you enter into the Service, that you authorize being released into the Service by a healthcare provider or state institution, including without limitation patient identifiable health information that may constitute “Protected Health Information” as defined by the Health Insurance Portability and Accountability Act of 1996, as amended (“HIPAA”). You acknowledge and agree that you are solely responsible for the individuals, and providing accurate information on the Designated Entity (ies) and healthcare providers that you authorize to access Your Data. You understand that this provision authorizes Vacmobile to electronically transmit Your Data to the entities and individuals identified above and on your Account. The purpose of this disclosure is to share information for reporting of vaccination or health credential information, for healthcare operations, treatment purposes and for Designated Entity’s purposes in accordance with applicable state and federal laws related to reporting health status for You, as applicable.

(b) You may revoke this authorization to which you have provided access to your Data by sending the request in writing to Vacmobile at [email protected] . Revocation of access to your Data includes revocation of access to any and all medical health information, provided access may continue to be granted until notice of the revocation is received by Vacmobile and Vacmobile has had a reasonable time to process such revocation. You acknowledge and agree that any disclosure of information prior to Vacmobile’s receipt of the written revocation notice is authorized. You understand that the health information contained in your Data may be protected by state and federal laws and by authorizing the release of the information you waive any rights to the privacy or security of such information. You also understand that the information may be re-disclosed by the receiving party. You understand that it is your obligation to ensure that any information, including your Data that you do not want disclosed to the third party is not provided through the Service and removed from your Data.

(c) This Authorization will remain valid for the later of the termination of this end user license agreement or twelve (12) months.


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