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By agreeing to these terms and conditions, I acknowledge that I am requesting Sansum Clinic to grant me access to my online health record, including the ability to communicate with my health care team via the internet using Sansum Clinic's application. In addition, I am asking Sansum Clinic to release my health information, including test results, to my online health record. I understand that medical providers are prohibited by California law from releasing certain test results to me electronically, and I may not be able to access all of my health information in my online health record. I understand that Sansum Clinic reserves the right to limit or discontinue my use of online patient services if I do not abide by these terms and conditions, or at their sole discretion.

Privacy and Security Policy - Sansum Clinic considers the privacy of your health information to be one of the most important elements in our relationship with you. Our responsibility to maintain the confidentiality of your health information is one that we take very seriously.

Summary of Requirements - Electronic Messaging should never be used for urgent matters. A valid and functional e-mail address must be provided. Your MyChart User Name and password should not be shared with anyone, including family members. Use of Sansum Clinic's MyChart application is intended for accessing private health information.

Use of Online Patient Services - I understand that Sansum Clinic's MyChart should never be used for urgent matters. I acknowledge the anticipated turnaround time for response to electronic messages is 1 to 3 business days. I understand that I have opted in to a service that provides electronic interaction with my clinician and care team.

For all urgent matters that I believe may immediately affect my health or well-being, I will, without delay, contact my clinician, and/or go to the emergency department of a local hospital, and/or dial 911.

I understand that my health care team may send me secure electronic messages via my MyChart account. These messages may contain information that is important to my health and medical care. It is my responsibility to monitor these messages. By entering my valid and functional e-mail address, I have enabled Sansum Clinic to notify me of messages sent to my MyChart inbox, and understand that these new message notifications cannot be disabled. I understand that maintaining my current contact information with Sansum Clinic is my responsibility and I will update my e-mail address on my account as needed.

I understand that in no event will Sansum Clinic, its affiliates, suppliers, or other third parties mentioned be liable for any damages whatsoever (including, without limitation, those resulting from lost profits, lost data, or business interruption) arising from the use, or the results of the use of MyChart, any websites linked to MyChart, or any materials or information contained at any or all such sites, whether based on warranty, contract, tort or any other legal theory and whether or not advised of the possibility of such damages.

Verification of Identity - I understand that my enrollment is contingent on verification of my identity either in person, on the phone, or by comparing my signature provided on the Release of Information form with my signature in my health record.

For purposes of establishing your identity and safeguarding it against identity theft or potential identity theft, Sansum Clinic requires that these MyChart Terms and Conditions are agreed to electronically within MyChart.

Online ID and Password - I understand that I must create a unique MyChart User Name and password to be used to access my health information. Inquiries and entries that I make will be logged with my identity.

I understand that it is extremely important that I keep my MyChart user name and password to my account completely confidential. If at any time I feel that the confidentiality of my password has been compromised, I will change it by going to the Security Settings section on the website. I understand that Sansum Clinic takes no responsibility for and disclaims any and all liability or consequential damages arising from a breach of health record confidentiality resulting from my sharing or losing my password. If Sansum Clinic discovers that I have inappropriately shared my password with another person, or that I have misused or abused my online access privileges in any way, my MyChart account may be deactivated by Sansum Clinic without prior notice.

I understand that I must not share my MyChart user ID and/or password with any other website, party, or vendor (for example, a mobile app or website that collects and displays health information). In doing so, I hold myself accountable for any interaction this has between MyChart and the third party and do not hold Sansum Clinic or its affiliates liable for my personal information and/or patient information being accessed by the third party, or for what they do with this information.

Deactivation of My Account - I understand that my account may be deactivated upon my request or at the discretion of Sansum Clinic.

Disclaimer - I understand that my account may not be available to me at all times due to maintenance, back-up procedures, unanticipated system failures, or other causes beyond the control of Sansum Clinic. Access is provided on an "as-is as-available" basis and Sansum Clinic does not guarantee that I will be able to access my account at all times. During times when my account is unavailable, other communication methods (e.g., telephone) should be used to contact Sansum Clinic.

I understand that Sansum Clinic takes no responsibility for and disclaims any and all liability arising from any inaccuracies or defects in software, communication lines, the virtual private network, the Internet or my Internet Service Provider (ISP), access system, computer hardware or software, or any other service or device that I use to access my account.

Photographs/Digital Images Uploaded by Patients - If I upload any photograph or digital image to MyChart, I hereby represent that the photograph or digital image:

  • Is of me (or if I'm acting on behalf a person to whom I have proxy access, of that person), and not of anyone else;
  • Directly pertains to a medical issue or question;
  • Is a true and accurate representation of my/their health status;
  • Has not been altered or misrepresented in any way;
  • That I have unlimited rights to the photograph or digital image and it is not subject to any copyright or trademark.

I understand and acknowledge that any communication I receive in response to a photograph or digital image is based upon what my physician is able see at the time it is viewed. Neither Sansum Clinic nor any physician has control over the clarity of how photographs or digital images are taken, uploaded, transmitted or ultimately appear on any computer or mobile device. In no event should I wait to seek immediate attention if I feel my condition is worsening or if it is different than what a physician is able to discern from the photograph or digital image. Any advice or recommendation I may receive from my physician based on submission of a photograph or digital image is not a substitute for a physician examination and/or an office visit. I further understand that Sansum Clinic has the right to remove any photo or digital image that it determines in its sole and absolute discretion is inappropriate, offensive, in violation of these Terms and Conditions of Use, in violation of any state or federal law, and/or does not otherwise belong in MyChart.

Telehealth - By accepting a video-conferencing appointment or invitation, I, as patient or patient’s legal representative, (“Patient”) acknowledge and consent to the use of telehealth technologies in the course of my medical treatment and authorize Sansum Clinic, its employed and/or contracted providers, including primary care practitioners, specialists, and/or subspecialists, its staff, and subcontractors (collectively, “Providers”) to discuss, evaluate and exchange my health information for the purposes of treatment and operations via telehealth. Telehealth may include live two-way audio and/or video communications and recordings. I understand that my health information may be used by Providers for diagnosis, therapy, follow-up and/or education, and may be shared with other individuals for scheduling, billing, laboratory services, or other related purposes as permitted by HIPAA and other applicable federal and state laws and regulations.

User/Device Data Collection - I understand that in some situations I can choose to connect my personal device(s) (such as mobile phones, pedometers, or heart rate monitors) to MyChart via a data interface. Any information collected or retained in this way will be used only to facilitate my health care and will not be disclosed, sold, or otherwise provided to any party not involved in my healthcare, unless required by law. Any information provided may be made part of my permanent clinical health record.

Use of Third-Party Services - You may choose to use other services provided by third parties in conjunction with your use of MyChart. Such services may include, but are not limited to, translation services, location services, and other third-party offerings. Any links to such services are provided for your convenience only. Neither Epic nor Sansum Clinic have control over the contents of these services, and neither Epic nor Sansum Clinic accept any responsibility for them or for any loss or damage that may arise from your use of them. Such services may require you to submit your information to a third party, which may result in a copy of your information be used and/or stored by a third party. If you decide to access any such services in conjunction with your use of MyChart, you do so entirely at your own risk and subject to the terms and conditions of use for such services.

Eligibility - Patients age 12 and older may request access to MyChart. Patients age 12-17 have access that is more limited than patients who are over 18. Patients age 11 and younger are not eligible for MyChart access.

Proxy Access - An adult with a MyChart account may grant proxy access to another adult by logging in to MyChart and submitting an electronic request.

An adult (18 or over) who is a patient representative or otherwise legally acting (specific documentation may be required) on behalf of another adult may request proxy access to that person's MyChart account by filling out the Consent for Proxy Access to MyChart and Protected Health Information form available here and submitting it using any of methods (fax, mail, email) described on the form.

We offer the option of proxy access for parents and guardians of patients age 12-17 ("Teens"). Proxy access to teens excludes information that may require patient consent, and is more limited than proxy access to children under age 12 or to adults over age 18. For proxy access to a teen's MyChart account, the patient themself must first have an active account. Please note that the MyChart account request must be made by the teen patient. This can be done online, or by calling the MyChart Help Desk at 805-898-3333. Once the teen has their own MyChart account, they have the option to grant others (age 18 and older) proxy access from within their own (teen) account.

A parent or legal guardian of a minor child (age 0-11) may request proxy access to their child's MyChart information by going in to the Sansum Clinic location where their child receives care, or by calling the MyChart Help Desk at 805-898-3333. No appointment is needed for proxy access requests.

With respect to minors, proxy access will only be granted to parties with parental rights or legal guardianship over the patient and only to the extent that the party requesting proxy access can demonstrate the legal right to the patient's medical information.

Sansum Clinic's identity verification and protection requirements apply to the patient as well as to those who are requesting proxy access to a patient's MyChart account. If proxy access is granted, the patient and the proxy will receive separate MyChart accounts. The patient may revoke proxy access at any time by logging in to their MyChart account. If a proxy's legal relationship with the patient changes, the proxy must inform the Clinic immediately by contacting Sansum Clinic Health Information Services, Release of Information (ROI) Department, 89 S. Patterson St., Santa Barbara, CA 93111.

Sansum Clinic reserves the right to revoke proxy access at any time and for any reason.

Questions, Compliments, Complaints and Contacts - For questions, compliments or complaints about MyChart, and for questions regarding these Terms and Conditions, including your rights as a userof MyChart or Proxy Access, please contact the MyChart Help Desk at (805) 898-3333, Monday-Friday from 8:00 AM-5:00 PM. The MyChart Help Desk may also be contacted by U.S. Mail at the following address:

Sansum Clinic
MyChart Help Desk
89 S. Patterson St.
Santa Barbara, CA 93111

Document version date: 6/9/2020