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PREMIER SPINE AND PAIN MANAGEMENT
Somerset, Hillsborough, Succasunna, Middletown, Clifton, Easton, Hewitt, Edison, Jersey City

9089041900

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(908) 904-1900

COMMUNICATION BY EMAIL/TEXT

Security Risks

Most standard email providers such as Gmail, Yahoo, Hotmail, etc. and most cellular providers do not provide a secured or encrypted means of communication. As a result, there is risk that any protected health information contained in an email or text message may be disclosed to, or intercepted by, unauthorized third parties. Additionally, email and text messages accessible through personal computers,laptops, or phones have inherent privacy risks especially when the email or cellular account is provided by an employer, when the account is not password protected, or the account is shared. Use of more secure communications, such as phone, fax or mail is preferred and always an available alternative.

Responsibility

When consenting to the use of email or text through such unsecured or unencrypted systems, you are accepting responsibility for any unauthorized access or disclosure to protected health information contained within the message. The Practice will not be responsible for unauthorized access of protected health information while in transmission and will not be responsible for safeguarding information once it isdelivered. The Practice will take steps to ensure that any email or text message with protected health information is protected prior to being sent to the requested address and will use the minimum necessaryamount of protected health information when communicating with you.

Additional Information

It is important to understand that emails and text messages will not be used to replace or facilitate communications between you and your physician and will not be considered private communications. There is no guarantee that the Practice will be actively monitoring emails and text messages, so responses and replies sent to or received by you or the Practice may be hours or days apart. Email and text messages may be inadvertently missed or errors in transmissions may occur. The Practice will not beresponsible for any issues caused by delays in communications. If you have an immediate need or an emergency situation, you must contact the Practice by telephone or dial 9-1-1 if applicable. Practice staff will be utilized to monitor the inbox in order to properly direct or respond to communications received.Therefore, any information considered sensitive should not be included in your communications. At the Practice’s discretion, any email or text message received or sent may become part of your medical record. By completing and signing this form, or by initiating contact with the Practice via email, text, or webform,IamacceptingthatPremiereSpineandPainManagementmaycommunicatewithmeviaemailor text message via the provided contact information and acknowledge the inherent limitations therein.


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