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Electronic Signature Consent and HIPAA Authorization

ELECTRONIC RECORD AND SIGNATURE DISCLOSURE

From time to time, Genview Diagnosis (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the Genview system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to 'I agree to use electronic records and signatures' before clicking 'CONFIRM' within the Genview system.

Getting paper copies

At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. If you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.20 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.

Withdrawing your consent

If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.

Consequences of changing your mind

If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the Genview system to receive required notices and consents electronically from us or to sign electronically documents from us.

All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the Genview system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below.

Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact Genview Diagnosis:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

To contact us by email send messages to: info@i24test.com To advise Genview Diagnosis of your new email address To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at info@i24test.com and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address. If you created a Genview account, you may update it with your new email address through your account preferences. To request paper copies from Genview Diagnosis

To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to info@i24test.com and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with Genview Diagnosis To inform us that you no longer wish to receive future notices and disclosures in electronic format you may send us an email to info@i24test.com and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process.

Required hardware and software

The minimum system requirements for using the Genview system may change over time. The current system requirements are:

  • On desktop devices: Google Chrome (latest version) or Mozilla Firefox (latest version) or Safari (Mac OS only) 6.2
  • On mobile devices: Apple iOS 7.0 or Android 4.0
  • Allow per session cookies
  • Recommended screen resolution: 1024 x 768 or greater

Acknowledging your access and consent to receive and sign documents electronically

To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to 'I agree to use electronic records and signatures' before clicking 'CONFIRM' within the Genview system.

By selecting the check-box next to 'I agree to use electronic records and signatures', you confirm that:

You can access and read this Electronic Record and Signature Disclosure; and You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and Until or unless you notify Genview Diagnosis as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by Genview Diagnosis during the course of your relationship with Genview Diagnosis

By indicating your consent below, you authorize Curative, Inc. and Curative Labs Inc. dba KorvaLabs Inc. to disclose the protected health information described below to the persons or entities identified in this authorization form.

AUTHORIZATION FOR DISCLOSURE OF COVID-19 TEST RESULTS

I hereby voluntarily authorize the disclosure of my COVID-19 test results, provided by Genview Diagnosis, to:

  • Me via email (), even though email is not a completely secure means of communication.
  • Me via SMS (), even though SMS is not a completely secure means of communication.

I also understand and agree to the following:

  • I may refuse to provide this authorization.
  • I may revoke this authorization at any time in writing emailed to Curative, Inc. and Curative Labs at info@i24test.com, except to the extent that action has been taken in reliance on this authorization.
  • If this authorization has not been revoked, it will terminate one year from the date of effectiveness below.
  • I have a right to request and receive a copy of this authorization.
  • Any information disclosed pursuant to this authorization may be subject to redisclosure by the recipient, and any redisclosure may not be subject to HIPAA.

This authorization is effective immediately upon clicking the button “Agree and continue” on this authorization page.

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5252 Hollister Street, Suite 520, Houston, Texas 77040