CNS E-mail Disclaimer

E-mail services should not be used to communicate emergency information. Use local emergency services or 911.

CNS will use reasonable means to protect the privacy of your health information sent by e-mail. However, because of the risks inherent to e-mail, CNS cannot guarantee that e-mail communications will be confidential. Additionally, CNS will not be liable in the event that you or anyone else inappropriately uses your e-mail. CNS will not be liable for improper disclosure of your health information that is not caused by CNS's intentional misconduct.

E-mail Risks and Your Responsibility

At the discretion of CNS, its staff, physicians and agents (CNS) and upon your agreement to the terms outlined within this electronic consent form, you may use e-mail to communicate with CNS. These e-mails may contain your personal health information. If you decide to use e-mail to communicate with CNS, you should be aware of the following risks and/or your responsibilities:

1. As the Internet is not secure or private, unauthorized people may be able to intercept, read and possibly modify e-mail you send or are sent by CNS.
2. You must protect your e-mail account, password and computer against access by unauthorized people.
3. Since e-mail can be used to spread viruses, some which cause e-mail messages to be sent to people who you do not intend to send e-mail messages to, you should install and maintain virus protection software on your PC.
4. Since e-mails can be copied, printed and forwarded by people to whom you send e-mails, you should be careful regarding whom you send e-mails.
5. As your employer may claim ownership of, or the right to access the e-mail account issued to you by your employer, you should avoid using an employer issued e-mail account to communicate with CNS.

Conditions For the Use of E-mail

By consenting to the use of e-mail with CNS, you agree that:

1. CNS may send you e-mails as appropriate appointment reminders, billing and reimbursement questions, and other related reasons. As such, CNS staff members, other than the recipient, may have access to e-mails that you send. Such access will only be to such persons who have a right to access your e-mail to provide services to you. Otherwise, CNS will not, otherwise, forward e-mails to independent third parties, except as authorized by you or required by law.
2. Although CNS will try to read and respond promptly to your e-mails, CNS staff may not read your e-mail immediately. Therefore, you should not use e-mail to communicate with CNS if there is an emergency or where you require an answer in a short period of time.
3. If your e-mail requires or asks for a response, and you have not received a response within a reasonable time period, it is your responsibility to follow up directly by calling CNS.
4. You should carefully consider the risk of using e-mail for the communication of sensitive medical information, such as, but not limited to, information regarding sexually transmitted diseases, AIDS/HIV, mental health, developmental disability, or substance abuse.
5. You should carefully word your e-mail messages so the information is provided clearly, yet briefly, and describes the information you intend to convey.
6. You are responsible for correcting any unclear or incorrect information.
7. CNS reserves the right to save your e-mail and include your e-mail or information contained within your e-mail in your medical record.
8. It is the client's responsibility to follow up and/or schedule an appointment if warranted or recommended by CNS.
9. E-mails may not be the only form of communication that CNS will use to communicate with you. Additionally, CNS may decide that it is not in your best interest to continue to communicate with you by e-mail. In such case, CNS will notify that it no longer intends to communicate with you by e-mail.