Amazon Clinic protects your health data by strictly adhering to the requirements of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA governs what Amazon Clinic and third-party healthcare providers can do with your Protected Health Information (PHI) and this includes information like your medication history, medical conditions, and treatment plan information. We are required by law to maintain the privacy and security of your health information.
Privacy questions, terms of use, and consents
Our approach to privacy
At Amazon Clinic, we're committed to protecting your privacy like we would our own. Not only because it's required by law, but because it's the right thing to do.
How we're different
Amazon Clinic lets you shop for healthcare by connecting you to multiple healthcare providers. You can choose the healthcare provider you want based on the things that matter most to you, like speed of service, price, or the types of treatments offered.
Amazon Clinic lets you shop for healthcare by connecting you to multiple healthcare providers. You can choose the healthcare provider you want based on the things that matter most to you, like speed of service, price, or the types of treatments offered.
What we do (and don’t do) with your information
We use your information to make your healthcare experience easier. We send it to your healthcare providers and pharmacies when you're being treated, and we save it so you won't have to fill out the same forms over and over again—even if your healthcare provider were to leave Amazon Clinic. We'll never sell your information to anyone and we don’t use your personal health information to market or advertise other products available on Amazon.com.
We use your information to make your healthcare experience easier. We send it to your healthcare providers and pharmacies when you're being treated, and we save it so you won't have to fill out the same forms over and over again—even if your healthcare provider were to leave Amazon Clinic. We'll never sell your information to anyone and we don’t use your personal health information to market or advertise other products available on Amazon.com.
We respect your preferences
If you don't want us to save your health information, you can still get care through Amazon Clinic. However, you should know that if the healthcare provider(s) you've used leave Amazon, we'll be required by law to delete your health information and you'll have to re-enter it if you visit us again.
If you don't want us to save your health information, you can still get care through Amazon Clinic. However, you should know that if the healthcare provider(s) you've used leave Amazon, we'll be required by law to delete your health information and you'll have to re-enter it if you visit us again.
You can change your mind
If you give us permission to save your health information, then change your mind, that's OK. To revoke your HIPAA Authorization, just email your request to clinic.privacy@amazon.clinic. Make sure to include your name, date of birth, address, and phone number, or download the HIPAA revocation form, fill it out, and send it as an attachment to your email.
If you give us permission to save your health information, then change your mind, that's OK. To revoke your HIPAA Authorization, just email your request to clinic.privacy@amazon.clinic. Make sure to include your name, date of birth, address, and phone number, or download the HIPAA revocation form, fill it out, and send it as an attachment to your email.
Security and privacy
How does Amazon Clinic protect my health data?
How is my health information used?
Amazon Clinic uses your health information (like your medical history, diagnoses, treatments, current medical condition, and use of prescription medications) to provide healthcare services to you via third-party healthcare providers. Amazon Clinic works with healthcare providers to provide you with telehealth services using your PHI. Each healthcare provider’s Notice of Privacy Practices governs the use of your PHI when you receive treatment from that provider, not the Amazon.com Privacy Notice. Please see your treating healthcare provider’s Notice of Privacy Practices, available to you on your provider’s Consents and Notices page, for more information on HIPAA, PHI, and how you may access your PHI.
How does Amazon Clinic protect my medical information?
Medical information that you provide to Amazon Clinic is protected by our practices and by law. Amazon Clinic complies with HIPAA and has high standards and practices for data privacy as we keep your personal information secure. At Amazon Clinic, your data is protected through the use of strong, HIPAA-compliant encryption methods.
What data does Amazon Clinic collect?
Amazon Clinic collects data for your virtual health visit and this includes information about your visit (like your messages with your clinician), as well as basic information like your name, date of birth, health information you provide on your intake form, and your payment information.
How does Amazon Clinic use and share data?
We will use and share your data as you have authorized through Amazon Clinic’s Terms of Use and HIPAA authorization. This includes sharing your health information with your treating healthcare provider to ensure that you receive treatment, and to provide you with health services.
Terms and conditions
Amazon Clinic Terms of Use
Last Updated: November 9th, 2022
Thank you for using Amazon Clinic. Amazon VHS LLC (“Amazon Clinic”) is a virtual healthcare storefront through which telehealth services are offered by individual third-party healthcare providers and provider groups (collectively, “HCPs”). Amazon Clinic makes website features and other products and services available to you when you visit the Amazon Clinic website, use Amazon Clinic products or services, interact or communicate with an HCP via our website, or interact or communicate with Amazon Clinic (collectively, “Amazon Clinic Services”).
These Amazon Clinic Terms of Use supplement the terms and conditions set forth in the Amazon.com Conditions of Use and Amazon.com Privacy Notice. Before using Amazon Clinic Services, please read the Amazon.com Conditions of Use, Amazon.com Privacy Notice, and these Amazon Clinic Terms of Use (collectively, the “Agreement”). By using Amazon Clinic Services, you are agreeing to be bound by the terms of the Agreement. If you do not agree to the terms of the Agreement, you may not use Amazon Clinic Services; instead, you may work directly with participating HCPs.
AMAZON CLINIC SERVICES
Through Amazon Clinic, physicians, physician assistants, and nurse practitioners practicing on their own or who are employed and/or contracted by HCPs that are provider groups (“Clinicians”) offer telehealth services to Amazon customers. Amazon does not practice medicine or nursing, and does not interfere with or otherwise influence the Clinicians’ exercise of their professional judgment in providing healthcare services. Each Clinician is responsible for exercising their own professional judgment and complying with all requirements applicable to their profession and license.
PRIVACY OF YOUR HEALTH INFORMATION
Protected Health Information (“PHI”) is defined in the Health Insurance Portability and Accountability Act of 1996 (commonly referred to as HIPAA), and includes information such as a person’s medical history, diagnoses, treatments, current medical condition, and use of prescription medications. On the Amazon Clinic storefront, HCPs will collect or use your PHI to provide you with telehealth services. As a service provider to the HCPs, Amazon Clinic will receive certain PHI to enable those services. When PHI is collected or used by an HCP (or is received by Amazon in its capacity as a service provider to an HCP) it is governed by the HCP’s Notice of Privacy Practices, and not the Amazon.com Privacy Notice. Please see the HCP’s Notices of Privacy Practices for more information on HIPAA, PHI, and how you may access your PHI.
ELIGIBILITY AND AVAILABILITY
You may only use Amazon Clinic Services if you are eligible. By using Amazon Clinic Services, you acknowledge and agree that (i) you are not enrolled in any Medicare or Medicaid program or plan; (ii) you will pay directly for any medical services provided and products or drugs prescribed to you; and (iii) HCPs will not bill any other third party, including a federal or state healthcare program, for such medical services or prescribed drugs or products. For more information on Amazon Clinic Services’ current eligibility criteria, please visit our FAQs. We reserve the right to make changes to our eligibility criteria at any time. In the event that you lose eligibility for Amazon Clinic Services we may suspend your access to Amazon Clinic Services, but you may still access your PHI in accordance with your chosen HCP’s Notice of Privacy Practices.
Certain Amazon Clinic Services are currently available in a limited service area. Through the Amazon Clinic website and/or the Amazon.com mobile application we determine which Amazon Clinic Services are available to you, based on your location. You agree to refrain from using any technology or technique to obscure or disguise your location when using Amazon Clinic Services.
AMAZON.COM PROFILE
You will need an Amazon.com profile to use Amazon Clinic. If you are under 18 or 65 or older, you may not use Amazon Clinic Services. You agree to provide and maintain true, current, and complete information about yourself in the profile. You may establish and use a personal identification number to create and access your Amazon Clinic Services. If you do not set a personal identification number, other people with whom you share your Amazon account might be able to access information regarding your Amazon Clinic visits, including treatment plans and correspondence with HCPs and their Clinicians. Each adult who shares an Amazon.com account with other members of their household will need to create their own profile in order to use the Amazon Clinic Services.
HEALTH-RELATED CONTENT
For health-related content provided by Amazon Clinic and not directly from an HCP, we try to be as accurate as possible, however such content is for reference only and describes general principles of healthcare and side effects related to common medications, and are not specific instructions for individual patients. If you have any questions about health-related content, please contact us at 855-682-2766 or reach out to your HCP.
PAYMENT OBLIGATIONS
You are responsible for payments for Amazon Clinic Services. If there is a problem charging your selected payment method for a purchase, we may charge any other valid payment method associated with your Amazon.com account.
COMMUNICATIONS WITH AMAZON CLINIC SERVICES
You consent to receive communications (including emails, texts, mobile push notifications, or notices and messages on Amazon.com, the Amazon Clinic website, or through other Amazon Clinic Services) by or on behalf of Amazon to any email address, phone number, or mobile device associated with your Amazon.com account or otherwise directly or indirectly provided to Amazon. Communications we send to you may include information about your treatment, or benefits, and, in connection with such communications, we may use pre-recorded/artificial voice messages and/or automatic dialing devices. If you choose to share access to your mobile phone, carrier account, email, or Amazon Clinic personal identification number with others, those individuals might also be able to see this information. Our HCPs’ Notices of Privacy Practices provide more information on how you may receive communications from us and from the HCPs with whom we work.
REFUNDS
Please see Amazon Clinic’s help content for information about refunds.
OTHER INFORMATION
The Amazon.com Privacy Notice governs all information gathered by Amazon in connection with Amazon Clinic Services that is not PHI (for example, version and time zone settings, device type, or operating system associated with the Amazon.com mobile application).
CONSENT TO CARE
On the Amazon Clinic virtual healthcare storefront, each HCP must obtain a patient’s consent in order to provide telehealth services. You will have the opportunity to review your chosen HCP’s patient consent for medical treatment (“Informed Consent”) prior to seeking telehealth services from that HCP. If you do not accept the Informed Consent, the HCP will not be able to provide telehealth services to you.
PRICING OF TELEHEALTH SERVICES
The total cost for the telehealth visit you choose, based on the HCP you choose, will be provided to you prior to engaging in the telehealth visit. By electronically consenting to receive a telehealth service, you are agreeing to pay all applicable charges for that service, regardless of the treatment outcome. At this time, insurance is not accepted for telehealth services provided through Amazon Clinic.
PRESCRIPTION MEDICATION
A Clinician may prescribe a medication if they determine it to be necessary to treat your condition. If you request that an HCP send your prescription to your preferred pharmacy, then you are responsible for picking up or arranging for delivery of the medication. You are responsible for providing the dispensing pharmacy with your health insurance information and for paying any charges due for medication, including co-pay, co-insurance, deductible, and all associated fees arising as a result of the prescription.
TERMINATION
Amazon may terminate your rights under this Agreement without notice if you fail to comply with any of its terms. Further, Amazon may terminate or suspend your access to and use of the Amazon Clinic Services and/or your Amazon Clinic profile without notice, for any reason, at any time. In case of such termination, Amazon may immediately revoke your access to Amazon Clinic Services without refunding any fees. If your Amazon Clinic profile is suspended or terminated, you may still access your PHI in accordance with your chosen HCP’s Notice of Privacy Practices. Amazon's failure to insist upon or enforce your strict compliance with this Agreement will not constitute a waiver of any of its rights.
MODIFICATIONS
We reserve the right to make changes to or end the Amazon Clinic Services at any time. We also reserve the right to make changes to the Agreement at any time, and your continued use of Amazon Clinic Services following the posting of changes to this Terms of Use Agreement means that you continue to agree to its terms, including the Amazon Clinic help content, and all other applicable rules, policies, and terms posted on the Amazon Clinic website. If any of these terms is deemed invalid, void, or for any reason unenforceable, that term is deemed severable and will not affect the validity and enforceability of any remaining terms.
DISCLAIMER OF LIABILITY FOR HCP SERVICES
HCPS ARE THIRD-PARTY PROVIDERS OF HEALTHCARE SERVICES. AMAZON HAS NO RESPONSIBILITY OR LIABILITY FOR HEALTHCARE SERVICES PROVIDED BY AN HCP. EACH HCP MAY CHANGE OR DISCONTINUE ITS HEALTHCARE SERVICES AT ANY TIME, AND AMAZON HAS NO OBLIGATION TO PROVIDE NOTICE TO YOU. AMAZON HEREBY DISCLAIMS ANY LIABILITY FOR ANY HEALTHCARE SERVICES PROVIDED BY AN HCP AND OBTAINED THROUGH THE AMAZON CLINIC SERVICES.
DISPUTES
This Agreement is governed by the laws of the State of Washington, without reference to its conflict of law rules. Each party agrees to exclusive personal jurisdiction and venue in the federal and state courts in King County, Washington, for any dispute arising out of this Agreement.
DISCLAIMER OF WARRANTIES AND LIMITATION OF LIABILITY
AMAZON HEREBY DISCLAIMS ANY LIABILITY FOR UNAVAILABILITY OF AMAZON CLINIC SERVICES. WITHOUT LIMITING THE DISCLAIMER OF WARRANTIES AND LIMITATION OF LIABILITY TERMS IN THE AMAZON.COM CONDITIONS OF USE OR THIS AGREEMENT, AND UNLESS OTHERWISE REQUIRED BY APPLICABLE LAW, IN NO EVENT WILL AMAZON’S AGGREGATE LIABILITY WITH RESPECT TO ANY CLAIM ARISING FROM OR RELATING TO THIS AGREEMENT OR YOUR USE OF THE AMAZON CLINIC SERVICES EXCEED FIVE HUNDRED DOLLARS ($500).
Thank you for using Amazon Clinic. Amazon VHS LLC (“Amazon Clinic”) is a virtual healthcare storefront through which telehealth services are offered by individual third-party healthcare providers and provider groups (collectively, “HCPs”). Amazon Clinic makes website features and other products and services available to you when you visit the Amazon Clinic website, use Amazon Clinic products or services, interact or communicate with an HCP via our website, or interact or communicate with Amazon Clinic (collectively, “Amazon Clinic Services”).
These Amazon Clinic Terms of Use supplement the terms and conditions set forth in the Amazon.com Conditions of Use and Amazon.com Privacy Notice. Before using Amazon Clinic Services, please read the Amazon.com Conditions of Use, Amazon.com Privacy Notice, and these Amazon Clinic Terms of Use (collectively, the “Agreement”). By using Amazon Clinic Services, you are agreeing to be bound by the terms of the Agreement. If you do not agree to the terms of the Agreement, you may not use Amazon Clinic Services; instead, you may work directly with participating HCPs.
AMAZON CLINIC SERVICES
Through Amazon Clinic, physicians, physician assistants, and nurse practitioners practicing on their own or who are employed and/or contracted by HCPs that are provider groups (“Clinicians”) offer telehealth services to Amazon customers. Amazon does not practice medicine or nursing, and does not interfere with or otherwise influence the Clinicians’ exercise of their professional judgment in providing healthcare services. Each Clinician is responsible for exercising their own professional judgment and complying with all requirements applicable to their profession and license.
PRIVACY OF YOUR HEALTH INFORMATION
Protected Health Information (“PHI”) is defined in the Health Insurance Portability and Accountability Act of 1996 (commonly referred to as HIPAA), and includes information such as a person’s medical history, diagnoses, treatments, current medical condition, and use of prescription medications. On the Amazon Clinic storefront, HCPs will collect or use your PHI to provide you with telehealth services. As a service provider to the HCPs, Amazon Clinic will receive certain PHI to enable those services. When PHI is collected or used by an HCP (or is received by Amazon in its capacity as a service provider to an HCP) it is governed by the HCP’s Notice of Privacy Practices, and not the Amazon.com Privacy Notice. Please see the HCP’s Notices of Privacy Practices for more information on HIPAA, PHI, and how you may access your PHI.
ELIGIBILITY AND AVAILABILITY
You may only use Amazon Clinic Services if you are eligible. By using Amazon Clinic Services, you acknowledge and agree that (i) you are not enrolled in any Medicare or Medicaid program or plan; (ii) you will pay directly for any medical services provided and products or drugs prescribed to you; and (iii) HCPs will not bill any other third party, including a federal or state healthcare program, for such medical services or prescribed drugs or products. For more information on Amazon Clinic Services’ current eligibility criteria, please visit our FAQs. We reserve the right to make changes to our eligibility criteria at any time. In the event that you lose eligibility for Amazon Clinic Services we may suspend your access to Amazon Clinic Services, but you may still access your PHI in accordance with your chosen HCP’s Notice of Privacy Practices.
Certain Amazon Clinic Services are currently available in a limited service area. Through the Amazon Clinic website and/or the Amazon.com mobile application we determine which Amazon Clinic Services are available to you, based on your location. You agree to refrain from using any technology or technique to obscure or disguise your location when using Amazon Clinic Services.
AMAZON.COM PROFILE
You will need an Amazon.com profile to use Amazon Clinic. If you are under 18 or 65 or older, you may not use Amazon Clinic Services. You agree to provide and maintain true, current, and complete information about yourself in the profile. You may establish and use a personal identification number to create and access your Amazon Clinic Services. If you do not set a personal identification number, other people with whom you share your Amazon account might be able to access information regarding your Amazon Clinic visits, including treatment plans and correspondence with HCPs and their Clinicians. Each adult who shares an Amazon.com account with other members of their household will need to create their own profile in order to use the Amazon Clinic Services.
HEALTH-RELATED CONTENT
For health-related content provided by Amazon Clinic and not directly from an HCP, we try to be as accurate as possible, however such content is for reference only and describes general principles of healthcare and side effects related to common medications, and are not specific instructions for individual patients. If you have any questions about health-related content, please contact us at 855-682-2766 or reach out to your HCP.
PAYMENT OBLIGATIONS
You are responsible for payments for Amazon Clinic Services. If there is a problem charging your selected payment method for a purchase, we may charge any other valid payment method associated with your Amazon.com account.
COMMUNICATIONS WITH AMAZON CLINIC SERVICES
You consent to receive communications (including emails, texts, mobile push notifications, or notices and messages on Amazon.com, the Amazon Clinic website, or through other Amazon Clinic Services) by or on behalf of Amazon to any email address, phone number, or mobile device associated with your Amazon.com account or otherwise directly or indirectly provided to Amazon. Communications we send to you may include information about your treatment, or benefits, and, in connection with such communications, we may use pre-recorded/artificial voice messages and/or automatic dialing devices. If you choose to share access to your mobile phone, carrier account, email, or Amazon Clinic personal identification number with others, those individuals might also be able to see this information. Our HCPs’ Notices of Privacy Practices provide more information on how you may receive communications from us and from the HCPs with whom we work.
REFUNDS
Please see Amazon Clinic’s help content for information about refunds.
OTHER INFORMATION
The Amazon.com Privacy Notice governs all information gathered by Amazon in connection with Amazon Clinic Services that is not PHI (for example, version and time zone settings, device type, or operating system associated with the Amazon.com mobile application).
CONSENT TO CARE
On the Amazon Clinic virtual healthcare storefront, each HCP must obtain a patient’s consent in order to provide telehealth services. You will have the opportunity to review your chosen HCP’s patient consent for medical treatment (“Informed Consent”) prior to seeking telehealth services from that HCP. If you do not accept the Informed Consent, the HCP will not be able to provide telehealth services to you.
PRICING OF TELEHEALTH SERVICES
The total cost for the telehealth visit you choose, based on the HCP you choose, will be provided to you prior to engaging in the telehealth visit. By electronically consenting to receive a telehealth service, you are agreeing to pay all applicable charges for that service, regardless of the treatment outcome. At this time, insurance is not accepted for telehealth services provided through Amazon Clinic.
PRESCRIPTION MEDICATION
A Clinician may prescribe a medication if they determine it to be necessary to treat your condition. If you request that an HCP send your prescription to your preferred pharmacy, then you are responsible for picking up or arranging for delivery of the medication. You are responsible for providing the dispensing pharmacy with your health insurance information and for paying any charges due for medication, including co-pay, co-insurance, deductible, and all associated fees arising as a result of the prescription.
TERMINATION
Amazon may terminate your rights under this Agreement without notice if you fail to comply with any of its terms. Further, Amazon may terminate or suspend your access to and use of the Amazon Clinic Services and/or your Amazon Clinic profile without notice, for any reason, at any time. In case of such termination, Amazon may immediately revoke your access to Amazon Clinic Services without refunding any fees. If your Amazon Clinic profile is suspended or terminated, you may still access your PHI in accordance with your chosen HCP’s Notice of Privacy Practices. Amazon's failure to insist upon or enforce your strict compliance with this Agreement will not constitute a waiver of any of its rights.
MODIFICATIONS
We reserve the right to make changes to or end the Amazon Clinic Services at any time. We also reserve the right to make changes to the Agreement at any time, and your continued use of Amazon Clinic Services following the posting of changes to this Terms of Use Agreement means that you continue to agree to its terms, including the Amazon Clinic help content, and all other applicable rules, policies, and terms posted on the Amazon Clinic website. If any of these terms is deemed invalid, void, or for any reason unenforceable, that term is deemed severable and will not affect the validity and enforceability of any remaining terms.
DISCLAIMER OF LIABILITY FOR HCP SERVICES
HCPS ARE THIRD-PARTY PROVIDERS OF HEALTHCARE SERVICES. AMAZON HAS NO RESPONSIBILITY OR LIABILITY FOR HEALTHCARE SERVICES PROVIDED BY AN HCP. EACH HCP MAY CHANGE OR DISCONTINUE ITS HEALTHCARE SERVICES AT ANY TIME, AND AMAZON HAS NO OBLIGATION TO PROVIDE NOTICE TO YOU. AMAZON HEREBY DISCLAIMS ANY LIABILITY FOR ANY HEALTHCARE SERVICES PROVIDED BY AN HCP AND OBTAINED THROUGH THE AMAZON CLINIC SERVICES.
DISPUTES
This Agreement is governed by the laws of the State of Washington, without reference to its conflict of law rules. Each party agrees to exclusive personal jurisdiction and venue in the federal and state courts in King County, Washington, for any dispute arising out of this Agreement.
DISCLAIMER OF WARRANTIES AND LIMITATION OF LIABILITY
AMAZON HEREBY DISCLAIMS ANY LIABILITY FOR UNAVAILABILITY OF AMAZON CLINIC SERVICES. WITHOUT LIMITING THE DISCLAIMER OF WARRANTIES AND LIMITATION OF LIABILITY TERMS IN THE AMAZON.COM CONDITIONS OF USE OR THIS AGREEMENT, AND UNLESS OTHERWISE REQUIRED BY APPLICABLE LAW, IN NO EVENT WILL AMAZON’S AGGREGATE LIABILITY WITH RESPECT TO ANY CLAIM ARISING FROM OR RELATING TO THIS AGREEMENT OR YOUR USE OF THE AMAZON CLINIC SERVICES EXCEED FIVE HUNDRED DOLLARS ($500).
Amazon Clinic HIPAA Authorization
AUTHORIZATION FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION TO AMAZON.COM SERVICES LLC, AMAZON VHS, LLC AND AFFILIATES
This is an Authorization for Use and Disclosure of Protected Health Information (the “Authorization”) in compliance with federal privacy laws, including the Health Insurance Portability and Accountability Act of 1996 and the Health Information Technology for Economic and Clinical Health Act (“HIPAA”).
I. Authorization for the Use or Disclosure of PHI
I authorize any physician, health care professional, laboratory, pharmacy, or other health care provider that has provided health care treatment or services to me or my dependent within Amazon Clinic (“HCP”) to disclose certain Protected Health Information that I or my dependent provides or receives through Amazon Clinic about me or my dependent (“PHI”) to Amazon.com Services LLC and its affiliates, including but not limited to Amazon VHS, LLC (collectively, “Amazon”) for the purposes described in this Authorization.
The information that any HCP is authorized to disclose to Amazon includes the following PHI:
1. Contact Information (for example, email address);
2. Demographic Information (for example, date of birth);
3. Account and Payment Information (for example, insurance information); and
4. My complete patient file, including medical and billing records related to the services that any HCP provides to me through Amazon Clinic.
Amazon may retain, use and disclose this information:
1. In the event an HCP who has provided services to me no longer offers services through Amazon Clinic, for the purposes of coordinating healthcare services on my behalf; and
2. To allow Amazon to update my Contact Information and Demographic Information for use in relation to any Amazon services, for example, to use Contact Information and Demographic Information to facilitate services from other providers.
II. Important Information About Your Rights
I understand that:
1. This Authorization is voluntary. Refusing to sign this Authorization will not prevent me from obtaining health care services from any HCP that provides telehealth services through Amazon Clinic by reaching out to the HCP directly. Information about how to contact an HCP directly can be obtained here.
2. I may revoke this Authorization at any time by sending a written revocation notice to Amazon using the instructions found here. The revocation will not have any effect on any disclosure that any HCP took in reliance on this Authorization before receiving my revocation notice.
3. Information disclosed pursuant to this Authorization may be re-disclosed by the recipient, and this redisclosure will no longer be protected by HIPAA.
4. I have a right to a copy of this Authorization.
5. This Authorization expires five years after I cease to receive any services from any HCP through Amazon Clinic.
A copy of Amazon Clinic’s HIPAA Authorization can be found here. If you have previously declined the HIPAA Authorization and now would like to consent, sign a copy of the form and email it to clinic.privacy@amazon.clinic.
This is an Authorization for Use and Disclosure of Protected Health Information (the “Authorization”) in compliance with federal privacy laws, including the Health Insurance Portability and Accountability Act of 1996 and the Health Information Technology for Economic and Clinical Health Act (“HIPAA”).
I. Authorization for the Use or Disclosure of PHI
I authorize any physician, health care professional, laboratory, pharmacy, or other health care provider that has provided health care treatment or services to me or my dependent within Amazon Clinic (“HCP”) to disclose certain Protected Health Information that I or my dependent provides or receives through Amazon Clinic about me or my dependent (“PHI”) to Amazon.com Services LLC and its affiliates, including but not limited to Amazon VHS, LLC (collectively, “Amazon”) for the purposes described in this Authorization.
The information that any HCP is authorized to disclose to Amazon includes the following PHI:
1. Contact Information (for example, email address);
2. Demographic Information (for example, date of birth);
3. Account and Payment Information (for example, insurance information); and
4. My complete patient file, including medical and billing records related to the services that any HCP provides to me through Amazon Clinic.
Amazon may retain, use and disclose this information:
1. In the event an HCP who has provided services to me no longer offers services through Amazon Clinic, for the purposes of coordinating healthcare services on my behalf; and
2. To allow Amazon to update my Contact Information and Demographic Information for use in relation to any Amazon services, for example, to use Contact Information and Demographic Information to facilitate services from other providers.
II. Important Information About Your Rights
I understand that:
1. This Authorization is voluntary. Refusing to sign this Authorization will not prevent me from obtaining health care services from any HCP that provides telehealth services through Amazon Clinic by reaching out to the HCP directly. Information about how to contact an HCP directly can be obtained here.
2. I may revoke this Authorization at any time by sending a written revocation notice to Amazon using the instructions found here. The revocation will not have any effect on any disclosure that any HCP took in reliance on this Authorization before receiving my revocation notice.
3. Information disclosed pursuant to this Authorization may be re-disclosed by the recipient, and this redisclosure will no longer be protected by HIPAA.
4. I have a right to a copy of this Authorization.
5. This Authorization expires five years after I cease to receive any services from any HCP through Amazon Clinic.
A copy of Amazon Clinic’s HIPAA Authorization can be found here. If you have previously declined the HIPAA Authorization and now would like to consent, sign a copy of the form and email it to clinic.privacy@amazon.clinic.
Revoke HIPAA Authorization
To revoke your HIPAA Authorization, email your request to clinic.privacy@amazon.clinic. Make sure to include your name, date of birth, address, and phone number, or download the revocation form, fill it out, and send it as an attachment to your email.
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