I hereby authorize Ennoble Care and my Provider to use electronic communications, such as email, text message, and voicemail to communicate with me or leave messages for me. I understand that these communications may include my health information, including appointment times, test/exam results, balances/cost estimates, or other health care information regarding my care and treatment. I understand that this electronic communication may be sent unencrypted and, therefore, include risk. Risks include:

• Electronic communications can be circulated, forwarded, and stored in numerous paper and electronic files.
• Electronic communications can be immediately broadcast worldwide and be received by both intended and unintended recipients.
• Electronic communications senders can misaddress e-mail/text/voice message.
• Electronic communications can be more easily falsified than handwritten or signed documents.
• Backup copies of e-mail may exist even after the sender or the recipient has deleted his or her copy.
• Employers and on-line services have a right to archive and inspect e-mails/text/voice messages transmitted through their systems.
• Electronic communications can be intercepted, altered, forwarded, or used without authorization or detection.
• Electronic communications can be used to introduce viruses into computer systems.
• Electronic communications may not be received by either party in a timely matter as it may be caught by junk/spam filters.

I acknowledge and accept the risks of sending and receiving health information via electronic communications (including those which are unencrypted), and authorize Ennoble Care and my Provider to use email, text message, and voicemail to communicate with me. I understand that there is no guarantee that any electronic communication will be read and responded to within any particular period of time and that, therefore, I should not use electronic communication for emergencies or other time sensitive matters. I agree to follow up on any electronic communication if a response is expected but not received in case of lost messages, and to inform Ennoble of changes in my email address or phone number using a contact method already verified with Ennoble. I agree to secure my own devices used to communicate with Ennoble and my Provider, and hold Ennoble and my Provider harmless for any unauthorized use, disclosure, or access to protected health information (PHI) sent to the contact information I provide.

I agree to indemnify and hold harmless Ennoble and my Provider from and against all losses, expenses, damages and costs, including reasonable attorney fees, relating to or arising from any use of electronic communications, information loss due to technical failure, my use of the Internet to communicate with Ennoble and my Provider, and any breach by me of these restrictions and conditions. Ennoble and my Provider does not warrant that electronic communications will be uninterrupted or error-free, that defects will be corrected, or that the Ennoble’s and my Provider’s electronic communications is free of viruses or other harmful components.

I understand that clinically relevant information will be documented in the medical record. I understand that I can revoke this consent at any time, but I must do so in writing.