Dr. Stark has offered to communicate using the following means of electronic communication (the "Services”):

• email via Enguard
• email, in-app messaging, phone calls, & text messaging via Kareo EHR

RISKS OF ELECTRONIC COMMUNICATION

Dr. Stark and Dr. Stark's staff will use reasonable means to protect the security and confidentiality of information sent and received using the Services. However, because of the risks outlined below, Dr. Stark and Dr. Stark's staff cannot guarantee the security and confidentiality of electronic communications:

• Use of electronic communications to discuss sensitive information can increase the risk of such information being disclosed to third parties.
• Despite reasonable efforts to protect the privacy and security of electronic communication, it is not possible to completely secure the information.
• Employers and online services may have a legal right to inspect and keep electronic communications that pass through their system.
• Electronic communications can introduce malware into a computer system,and potentially damage or disrupt the computer, networks, and security settings.
• Electronic communications can be forwarded, intercepted, circulated, stored,or even changed without the knowledge or permission of Dr. Stark, Dr. Stark's staff, or the patient.
• Even after the sender and recipient have deleted copies of electronic communications, back-up copies may exist on a computer system.
• Electronic communications maybe disclosed in accordance with a duty to report or a court order.
• Email, text messages, and instant messages can more easily be misdirected, resulting in increased risk of being received by unintended and unknown recipients.
• Email, text messages, and instant messages can be easier to falsify than handwritten or signed hard copies. It is not feasible to verify the true identity of the sender, or to ensure that only the recipient can read the message once it has been sent.

CONDITIONS OF USING THE SERVICES

• While the Physician will attempt to review and respond in a timely fashion to your electronic communication, Dr. Stark and Dr. Stark's staff cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time. The Services will not be used for medical emergencies or other time-sensitive matters.
• If your electronic communication requires or invites a response from the Physician and you have not received a response within a reasonable time period, it is your responsibility to follow up to determine whether the intended recipient received the electronic communication and when the recipient will respond.
• Electronic communication is not an appropriate substitute for in-person or over-the-telephone communication or clinical examinations, where appropriate, or for attending the hospital or ER when needed. You are responsible for following up on Dr. Stark's and his staff's electronic communication and for scheduling appointments where warranted.
• Electronic communications concerning diagnosis or treatment may be printed or transcribed in full and made part of your medical record. Other individuals authorized to access the medical record, such as staff and billing personnel, may have access to those communications.
• Dr. Stark may forward electronic communications to staff and those involved in the delivery and administration of your care. Dr. Stark and Dr. Stark's staff will not forward electronic communications to third parties, including family members, without your prior written consent, except as authorized or required by law.
• Dr Stark and Dr Stark's staff are not responsible for information loss due to technical failures associated with your software or internet service provider.

BEST PRACTICES FOR USING THE SERVICES

• Inform Dr. Stark or Dr. Stark's staff of any changes in your/the patient’s email address, mobile phone number, or other account information necessary to communicate via the Services. 
• Include in the message’s subject line an appropriate description of the nature of the communication (eg, “prescription renewal”), and your/the patient's full name in the body of the message.
• Review all electronic communications to ensure they are clear and that all relevant information is provided before sending to the physician.
• Following receipt of an electronic communication from Dr. Stark, send a reply message or allow “read receipts” to be sent.
• Reasonably limit or avoid using an employer’s or other third party’s computer.
• Take precautions to preserve the confidentiality of electronic communications, such as using screen savers and safeguarding computer passwords.
• Withdraw consent for use of the Services only by written communication, including a signature and date, to Dr. Stark or Dr. Stark's staff.
• If you require immediate assistance, or if your condition appears serious or rapidly worsens, you should not rely on the Services. Rather, you should call Dr. Stark's office or take other measures as appropriate, such as going to the nearest ER or urgent care clinic.

PATIENT ACKNOWLEDGMENT AND AGREEMENT

I acknowledge that I have read and fully understand the risks, limitations, conditions of use, and instructions for use of the selected electronic communication Services more fully described above. I understand and accept the risks outlined above, associated with the use of the Services in communications with the Dr. Stark and Dr. Stark's staff. I consent to the conditions and will follow the instructions above, as well as any other conditions that Dr. Stark may impose on communications with patients using the Services.

Every good faith effort will be made by Dr. Stark and Dr. Stark's staff to protect sensitive information sent via the Services. I acknowledge and understand that despite this, it is possible that communications with Dr. Stark or Dr. Stark's staff using the Services may not be encrypted. Despite this, I agree to communicate with Dr. Stark or Dr. Stark's staff using these Services with a full understanding of the risk.

I acknowledge that either I or Dr. Stark may, at any time, withdraw the option of communicating electronically through the Services upon providing written notice.