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Medebound HEALTH User

Terms of Agreement

1. Overview


1.1 Medebound HEALTH, headquartered in New York, USA, is an international medical services company specializing in U.S. second opinions, treatment coordination, and access to novel therapies in the US.


1.2 Medebound LLC is the contracting entity referred to herein as "the Company" or "Medebound HEALTH."


1.3 The client or their family member ("Client" or "User") seeks to obtain medical consultation and related services via the Medebound HEALTH platform ("Platform").


1.4 The Client voluntarily engages Medebound HEALTH for health management and consultation services. Any translated documents, reports, or advice are informational only. Decisions should be discussed with and confirmed by the patient’s local treating physician.


1.5 This agreement becomes effective upon execution and remains in force until the completion of services.



2. Physician-Patient Relationship and Disclaimer


2.1 U.S. second opinion consultations are for reference purposes only. Treatment decisions should be made jointly by the client and their local physician. The legal physician-patient relationship exists between the client and their local physician—not with the U.S. remote consulting physician.


2.2 If the client visits the U.S. physician in person and receives treatment, a direct physician-patient relationship is established with that physician.


2.3 Medebound HEALTH strives to offer the most accurate advice within its capabilities. However, clients understand Medebound HEALTH and the U.S. doctors are not liable for any treatment decisions made based on the second opinion, and accept the risks of relying on any information provided under this agreement. The Clients confirm that they voluntarily request this service and understand its limitations.


2.4 Clients understand remote consultations differ from in-person visits and are subject to limitations due to lack of direct examination. Expert advice is not guaranteed to be helpful. Clients must contact local emergency services for worsening conditions.


2.5 Clients acknowledge that Medebound HEALTH facilitates a second opinion or consultation from a U.S. physician, but does not itself provide medical care.


3. Client Account and Medical Record Management


3.1 All services include the creation of a personal client account for storing medical information and service records.


3.2 Clients must provide complete and accurate medical documentation.


3.3 After service completion, Medebound HEALTH may use anonymized data for marketing or research, subject to identity protection.


3.4 Clients can request the removal of such usage, and Medebound HEALTH will act promptly, though removal from already published materials may not be possible.


4. Fees and Payment


4.1 Selected service:

Physicians at First attempt with MDACC; if unsuccessful, then MSKCC, followed by Dana-Farber.


(Reference: MDACC, MSKCC, Dana Farber and other prestigious hospitals agreed with the client)

(Reference: $2000-$3000 assistant or associate professor, $4000 full professor or direct-level physician).

(Reference: $3000-$4500 assistant or associate professor, $6000 full professor or direct-level physician).

4.2 Payment Terms:


50% payment (or $1500 if undetermined) must be made within 2 business days after signing to initiate service.  The remainder must be made once the doctor has confirmed the schedule.  The payment is non-refundable once the doctor has started reviewing your case. 

Please select one:

50% Payment
US$

or

$1500
US$

5. Miscellaneous


5.1 Copies: Multiple copies may be executed and shall all be considered part of this agreement.



5.2 Governing Law: Subject to laws of the United States.



5.3 Force Majeure: Parties are not liable for delays caused by uncontrollable events if they notify the other party promptly.



5.4 Dispute Resolution: Disputes to be resolved via negotiation, or if unsuccessful, via litigation in the jurisdiction of the contracted company.



5.5 Waiver and Amendment: No waiver shall be valid unless in writing. No changes unless mutually confirmed in writing.



5.6 Notices: Notices may be delivered via email. Date of delivery as per earliest record.



5.7 Headings: Are for convenience and do not affect interpretation.



5.8 Validity: If any provision is deemed invalid, the rest of the agreement remains effective.



5.9 Commitment: Clients confirm they’ve sought independent legal/medical counsel before signing.

I authorize Medebound HEALTH to release the patient’s medical records for expert review and consultation. I confirm I have read the full agreement, including the disclaimer and understand the implications.


เลือกโหมดการวาดไว้ การวาดต้องใช้เมาส์หรือหน้าจอสัมผัส เพื่อการเข้าถึงผ่านคีย์บอร์ด ให้เลือก "พิมพ์" หรือ "อัปโหลด"
Date
วัน
เดือน
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Appendix I: Premium Second Opinion Service Process (Written/Video)

Step 1: Upload Medical Records

Patients can email their complete medical records to our medical case team. We will create an account on the platform for them.


Step 2: Sign the 'User Service Agreement'

Print, sign, scan, and send the signed agreement via email to our medical case team.

Note: Please return the full agreement, not just the signature page. Payment must also be completed.


Step 3: Organize Medical Records

Within 1-2 business days of receiving complete documentation, we will organize a professional English medical summary. If records are incomplete, our medical team will contact the patient/family immediately. We will assist in framing major questions to ask the U.S. doctors.


Written Second Opinion:


Step 4 Written Second Opinion: First Round of Written Report

Within 5-7 business days after receiving complete records and signed agreement, a U.S. medical expert provides the first written report.


Step 5 Written Second Opinion: Second Round of Written Report

Within 3 days of receiving the first report, clients may submit up to 3 follow-up questions. Once answered, the case is considered closed.


Step 6 Written Second Opinion: Feedback

Clients may provide feedback via the platform or through a service evaluation form.


Video Second Opinion:


Step 4 Video Second Opinion: Schedule Video Consultation

Coordinate time among the patient, doctor, and interpreter (if needed). The video can occur as soon as one week later.


Step 5 Video Second Opinion: Technical Setup and Test

Test internet and tools in advance.


Step 6 Video Second Opinion: Formal Video Consultation

~40 minute session focusing on the three pre-submitted questions. Additional questions may be discussed if time allows.


Step 7 Video Second Opinion: Post-Consultation Summary

Clarifying questions may be asked after the consultation. A written summary of the session will be provided within 3 business days. The case is then closed and feedback collected.


Appendix II: HIPAA Authorization for Medical Information

Authorization to Use and Disclose Protected Health Information


Pursuant to HIPAA (45 CFR 160 and 164), I, hereby authorize Medebound HEALTH and its healthcare providers to use and/or disclose protected health information (PHI) of the patient.


This authorization permits Medebound HEALTH to disclose PHI to designated U.S. healthcare providers for the purposes of remote consultation, translation, or submission for medical review and storage in the U.S.


Scope of Authorization (Please select one):


This authorization is valid for 2 years from the date of signature. Medebound HEALTH will destroy the PHI after expiration unless otherwise governed by third-party data retention policies.

เลือกโหมดการวาดไว้ การวาดต้องใช้เมาส์หรือหน้าจอสัมผัส เพื่อการเข้าถึงผ่านคีย์บอร์ด ให้เลือก "พิมพ์" หรือ "อัปโหลด"
Date
วัน
เดือน
ปี
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