E-Signature Consumer Disclosure

Disclaimer and Consumer Disclosure

From time to time, Aspire Medical Group may be required by law to provide you certain written notices or disclosures. Described below are the terms and conditions for providing you with such notices and disclosures electronically. Please read the information below carefully and thoroughly.

Electronic Records and Signatures

By using our website, mobile application, and services, you agree to the use of electronic records and signatures in your interactions with Aspire Medical Group, P.C. This means that any document or agreement you complete with us electronically will carry the same legal effect as a handwritten signature or paper document.

You have the right to receive any required notices, disclosures, agreements, and other documents in paper format instead of electronically. To obtain a paper copy of any document, withdraw your consent to electronic records, or update your contact information, please contact us at info@aspiremedgroup.com. You will not be charged any fee for paper copies or for withdrawing consent. Please note that withdrawing consent for electronic records may impact your ability to use certain services.

Consumer Disclosure for Use of Electronic Signatures

1. Consent: By clicking to sign this form or by signing electronically, you acknowledge that you are providing your electronic signature and are legally bound by the terms of the agreement.

2. Access: You affirm that you have the necessary hardware and software to view, download, and store electronic records, including an updated internet browser and PDF reader.

3. Right to Withdraw: You have the right to withdraw consent to use electronic signatures or records at any time by notifying us in writing. If you withdraw your consent, we will provide paper versions of the documents for future transactions.

4. Hardware and Software Requirements: To view and sign documents electronically, you must have access to:

• An internet-connected device
• A web browser (Google Chrome, Firefox, Safari, etc.)
• Adobe Reader or other software capable of opening PDF documents
• An email account for communications

Data Collection and Use Disclosure

Aspire Medical Group collects personal information as described in our Privacy Policy, including but not limited to contact information, medical history, and demographic details. This information is used to provide healthcare services, process transactions, and for communication purposes. Your data will be handled in compliance with HIPAA and applicable state and federal privacy laws.

We may use third-party service providers to assist with electronic communications, recordkeeping, or processing payments. These providers are required to adhere to strict confidentiality and data protection standards.

Cookies and Trackers

We use cookies and similar tracking technologies on our website and mobile app to enhance your user experience and provide essential services. By using our website, you consent to the use of these technologies. You can adjust your browser settings to refuse cookies or alert you when cookies are being used, though this may limit your ability to fully interact with certain features.

Getting paper copies
You are not required to receive notices and disclosures or sign documents electronically. If you prefer not to do so, you may request to receive paper copies and withdraw your consent at any time as described below.

At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. The minimum system requirements for using our platform may change over time. Use of the service requires a standards compliant web browser which supports HTTPS protocol, HTML, and cookies. Viewing PDF documents requiring additional software such as Adobe Reader or similar.

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. If at any point after withdrawing consent you proceed forward and use the electronic signature system, you are once again consenting to receive notices, disclosures, or documents electronically. You may withdraw consent to receive electronic notices and disclosures and optionally electronic signatures by following the procedures 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.

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 our platform or via email 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.

Requesting paper copies, withdrawing consent, and updating contact information
To request paper copies of documents, withdraw consent to conduct business electronically and receive documents, notices, or disclosures electronically or sign documents electronically, please contact us by sending an email to info@aspiremedgroup.com or by postal mail at:

 Aspire Medical Group                                                                                         ATTN: Compliance                                                                                         275 Turnpike St Ste 206                                                                             Canton, MA 02021                                                                                             

Include the following information:

• Requesting Paper Copies: Please provide your name, email, telephone number, postal address and document title.
• Withdraw Consent: Please provide your name, email, date, telephone number, postal address.
• Update Contact Information: Please provide your name, email, telephone number and postal address. 

• By signing this document, you acknowledge that you have read and understood the terms and information contained in the Consumer Disclosure Regarding Electronic Business Transactions, Receiving Electronic Notices and Disclosures, and Signing Documents Electronically as outlined above. You confirm that you had ample opportunity to ask questions and seek clarification about anything unclear to you.
• By proceeding and signing this document, you agree that you have reviewed the consumer disclosure information and consent to transact business using electronic communications, to receive notices and disclosures electronically, and to utilize electronic signatures in lieu of paper documents.
• This electronic signature service is provided on behalf of Aspire Medical Group and its affiliated partners.
• By signing this form, you agree to use electronic records and signatures and acknowledge that you have read the related consumer disclosure.