Agreements

1. Patient-Clinician Relationship

By your signature, you acknowledge that you are voluntarily becoming a client of Inspire Pediatrics and its medical group or affiliated clinician. This applies to any clinician providing interim coverage.

2. Inspire Pediatrics Services

As a client, you are eligible to receive telehealth and in-home services. 

Telehealth subscriptions: Subscription services include unlimited secure texting and video visits, subject to availability.

Availability: Inspire Pediatrics will make every attempt to answer all questions and requests in a timely manner and provide adequate opportunity for appointments, but this is not a guaranteed response or appointment time. In general, Inspire Pediatrics will be available Sunday-Friday 8am-8pm within 4 hours, but this is subject to change. Major service disruptions or deviations from this schedule will be publicized through email or secure text notifications.

Inspire Pediatrics is not an emergency service, and any concerns or complaints that cannot wait should be addressed through in-person care at an emergency department or urgent care. 

In-home services: With additional purchase (or occasionally as a part of your subscription package at the discretion of Inspire Pediatrics) you may be eligible to receive in-home care, which can include physical exam, measurement of vital signs, rapid viral or urine testing, and consultation. These services are subject to availability.

By entering into this Membership Agreement, you acknowledge that Inspire Pediatrics does not provide health insurance coverage and that this is not a contract for insurance. Inspire Pediatrics provides only the services specifically described herein and additional costs may be incurred for laboratory, medical imaging, surgery, specialist care, emergency department visits, and hospitalization required outside Inspire Pediatrics services. Inspire Pediatrics encourages you to combine membership with appropriate health insurance coverage.

3. Fees and Payment

Inspire Pediatrics charges a subscription, available monthly, Bianually or Yearly. These may be paid in full at the time or sale, or may be set up on a payment plan at the discretion of Inspire Pediatrics, which does not change the commitment time to the subscription. 

Subscriptions (aside from the Newborn Package) automatically renew, but can be canceled at any time by emailing laura@inspirepediatrics.com. Inspire Pediatrics will notify each client before this automatic renewal. 

4. Your Medical Information

Your privacy is very important to us and you control the use of your personal information. Inspire Pediatrics has put important safeguards in place to make sure your medical information is protected and safe to maintain its confidentiality as required by State and Federal Agencies.

Inspire Pediatrics seeks to work together with you to give you the best health care possible. Having access to your medical information will help your clinician give you the best possible care because he/she will have the most up-to-date information about your health. Therefore, as allowed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and to help us give you the right care, in the right place and at the right time, your health plan and its contractors and agents may electronically share with us your health-related information (including your “protected health information” as defined by HIPAA). Such shared health-related information may include things like visits to the doctor or hospital, medical conditions, current and past prescriptions, biometric data (height, weight, body fat percentage, etc.) and other health status-related information. 

5. Digital Communications Risks and Conditions

Inspire Pediatrics offers members the ability to send and receive emails and texts to and from their care team. While Inspire Pediatrics takes many precautions to protect your information and the security of the emails and texts it sends, there are still risks.

Risks:

Transmitting patient information by email or text has a number of risks. These risks include but are not limited to the following:

Email and texts can be circulated, forwarded, stored electronically and on paper, and broadcast to unintended recipients.

Email and text senders can readily misaddress an email or text.

Email and texts can be intercepted, altered, forwarded or used without authorization or detection.

Emails and texts may not be secure, and therefore it is possible that the confidentiality of such communications may be breached by a third party.

Email and text service providers may have access to your emails and texts.

 

Conditions:

Inspire Pediatrics is not liable for improper disclosure of confidential information that is not caused by Inspire Pediatric’s misconduct. You must acknowledge and consent to the following conditions:

Email is not appropriate and should not be used for urgent or emergency situations. Secure texting is also not meant for urgent or emergent situations. Please call 911 in the event of a medical emergency.

Inspire Pediatrics may send you texts and emails as necessary for your diagnosis, treatment, billing, eligibility and other handling. You should not use email or for sensitive communications (e.g., AIDS/HIV, mental health, developmental disability or substance abuse).

You are responsible for protecting your email account or telephone password or other means of access to your email or text. Inspire Pediatrics is not liable for breaches of confidentiality involving your email or telephone accounts that are caused by you or any third party.

Inspire Pediatrics recommends that you download and use the Spruce app for texting and secure email communications. Should you prefer to send an email, please do not use gmail to send patient information. Instead, you may use hello@inspirepediatrics.sprucecare.com

 

By signing this Membership Agreement, you acknowledge that you have received and read the above information. 

Recommendations and Instructions:

If you wish to send and receive emails or texts from Inspire Pediatrics regarding your care and treatment, you:

Should limit or avoid use of public computers and public networks.

Should promptly inform Inspire Pediatrics of changes in your email address or telephone number.

Before sending emails or texts containing personal health information to Inspire Pediatrics, you should:

Ensure the email or text is addressed to the intended recipient.

List the key topic in the email subject line.

Put your name in the body of the email or text.

Take precautions to preserve the confidentiality of your emails or texts. Once Inspire Pediatrics sends an email or text from its network, it has no control over its confidentiality or security.

6. Term and Termination

This Membership Agreement shall begin upon the Effective Date and shall continue for the term agreed upon, unless it is terminated before the effective date by communicating intentions with Inspire Pediatrics. 

7. Complaints

Inspire Pediatrics strives to provide excellent care, and wants you to be happy with our services!

If you have a complaint, please contact Inspire Pediatrics in any of the following ways and we will try to make it right:

Email: laura@inspirepediatrics.com 

Phone: 720-807-2011

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TELEMEDICINE AGREEMENT

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I hereby release and hold harmless Inspire Pediatrics and all members of my care team from any loss of data or information due to technical failures associated with the telehealth/telemedicine service.
I understand and agree that the health information I provide at the time of my telehealth/telemedicine service may be the only source of health information used by the medical professionals during the course of my evaluation and treatment at the time of my telehealth/telemedicine visit, and that such professionals may not have access to my full medical record. 
I understand that diagnosis via telehealth is based on limited information using photos, video and written information that I provide which may or may not represent my child’s actual condition. I understand that I may still need to visit an in person provider after a telemedicine visit to further evaluate my child’s condition, and that it is my responsibility to seek in person care when necessary.

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