Account Setup

Sign Up

Thank you for signing up for the Medical Relevance medical histories. The information below is required to deliver the medical histories to your office. You can receive them by fax or email, whichever you choose. An access code relates to the fax or email so no contact information is open to patients. The access code can be changed at any time, and you are encouraged to change it as often as you like. THE ACCESS CODE IS NOT CASE SENSITIVE.

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First Name:

Last Name:

Medical Practice
Business Name:

Address Line 1:

Address Line 2:

City:

State:

Postal Code:

Phone Number 1:

Ext:

Phone Number 2:

Ext:

Information for Receiving Medical Histories

Signing Up For:

Fax Email

Office Administrator's Name:

(Recommended)

Access Code:

Verify Access Code:

(Your email address will be your user name)

Your Email Address:

Verify Email Address:

Password must be between 4 and 20 alpha/numeric characters long

Password:

Verify Password:

Terms & Conditions:

I Agree

September 23, 2007. These are the terms and conditions between you and Medical Relevance, Inc. (“Medical Relevance”) that govern the use of this website, the use of Medical Relevance Medical Histories (“Medical Histories”), and payment for Medical Histories used by your patients, and are collectively referred to as the “Agreement.” To agree to these terms and conditions click “Agree.” If you do not agree to these terms and conditions, do not click “Agree,” and do not use the service. You must accept the terms and conditions in this Agreement in their entirety; no changes, additions or deletions will be accepted.

Definition of Service. Medical Relevance is the provider of internet based Medical Histories which allows you to have your patients take an anonymous computerized patient interview, at no cost to them, using any computer logged into the Internet, and while connected to the patient affiliated website, visitnote.com. By relating your access code with a corresponding email or fax address, the completed Medical History is sent to your office, where you can identify the patient and use the completed history report during the patient examination. The procedure outlined in this paragraph is collectively termed the “Service” and is governed under certain terms associated with this Agreement.

Policies and Rules. The following policies and rules represent important requirements you agree to perform.

a. Set Up an Account. Once you set up an account with Medical Relevance, you will be free to do as many Medical Histories as you wish so long as your account remains in good standing.

b. Allow Only Confirmed Patients with Appointments. Only your patients with a confirmed office appointment shall be provided your access code and allowed to use the Service.

c.Receive Medical History Reports. Medical Histories will be sent to your office and you are required to receive these reports in their totality, or report errors to Medical Relevance.

d. Confirm Patient Identity. Once Medical Histories are received, you or your office will be required to confirm the patient’s identity based on the cover sheet requirements provided with each Medical History, which must be completed using information from your appointment book.

User Account and Security.

a. Account Confidentiality. Once you sign up and become a registered user, you are entitled to offer Medical Histories to any of your patients, at any time, and for any purpose subject to all the inclusive terms and conditions of this agreement. You should not reveal your account information to anyone else, nor should you receive or use the account information of any other registered user. You are entirely responsible for all activities that occur on or through your account, and you agree to notify Medical Relevance of any unauthorized use of your account.

b. Maintenance of Access Code. You must provide your Access Code to allow your patients to take Medical Histories. You should change your Access Code on a regular basis, of if any unauthorized use of the Medical Histories has occurred using your Access Code. Medical Relevance will temporarily close your account if your Access Code is found to be compromised and it will be your responsibility to update your Access Code in order to reauthorize your account.

c. Patient Identification. The Medical Histories you receive will not have any patients name on them to protect patient identities. You will be required to identify the patient’s name for every Medical History you receive by comparing the appointment time and date located on the cover page attached to each Medical History to the person associated with the appointment time and date on your medical appointments calendar. Medical Relevance will not be responsible for any errors associated with incorrect identification of patients.

d. Pricing and Use. Pricing is $0.50 for each Medical History that is completed by each patient using your Access Code and sent to your office by email.&nbsp; Pricing is $0.60 for each completed history sent to your office by fax.&nbsp; Medical Relevance reserves the right to change pricing at any time, and will notify you of any impending change by email.

Billing and Payments. You agree to pay for all Medical Histories purchased from Medical Relevance. Billing will be direct to your credit card you designate during the registration process on the initial date you sign up and every thirty days from then on. Monthly billing will be a minimum of $5, if receiving histories by email, which will entitle you to 10 free medical histories for the next thirty days. Monthly billing will be a minimum of $6, if receiving histories by fax, which will entitle you to 10 free medical histories for the next 30 days.&nbsp; Additional Medical Histories will be billed at the current per-history pricing. If you wish to designate a different credit card or if there is a change in your credit card, you must update your account information, and may result in a temporary disruption of the Service. There is no term associated with the Service, and you may cancel Service at any time. You will be billed for any Medical Histories used up to the cancellation date of your Sevice.

Refunds. In your account area, you will have access to a complete list of all the Medical Histories which have been taken in any given month. At any time if you feel a Medical History was incorrectly billed, you have the option of asking for and obtaining a refund. Refunds will be credited to the current credit card on file immediately on request.

Privacy Policy. All account information is protected by Medical Relevance, and any transactional information related to billing or credit cards is encrypted using SSL technology. Medical Relevance will not provide any of your account information to any third party.

Copyright. The products and technology described in the medicalrelevance.com and visitnote.com websites may be subject to copyright and intellectual property rights reserved by Medical Relevance or other third parties, and no license is granted or implied with respect to those rights.

Changes to Terms of Agreement. Medical Relevance reserves the right to change these terms and conditions at any time by posting changes on this website. It is your responsibility to review the terms and conditions regularly to ensure you are aware of the latest terms and conditions. Your use of this website after a change has been posted will be deemed to signify your acceptance of the modified terms and conditions. We recommend that you print off and retain for your records a copy of these terms and conditions from time to time.

Disclaimers. While Medical Relevance has taken care in the preparation of the contents of this website, and the affiliated patient, visitnote.com, the information, names, images, pictures, logos, icons regarding or relating to Medical Relevance and its associated partner companies are provided on an ‘as is’ basis and without any representation or endorsement being made and without any warranty of any kind, whether express or implied, including but not limited to, any implied warranties of satisfactory quality, fitness for a particular purpose, non-infringement, compatibility, security and accuracy. Each Medical History represents a best-effort basis to provide medical background information relating to any patient’s specific medical condition, but it is your responsibility to use this information in a manner deemed fit for each patient. To the extent permitted by law, all such terms and warranties are hereby excluded. In no event will Medical Relevance be liable for any losses sustained and arising out of or in connection with use of this website including, without limitation, loss of profits, loss of data or loss of goodwill (in all these cases whether direct or indirect) nor any indirect, economic, consequential or special loss.

Jurisdiction. The Medical Relevance Services are available only in the United States. The information on this Web Site is not directed to anyone other than single physician practitioners located in the United States. The terms and conditions described herein shall be governed by and construed in the accordance with the laws of the State of California.