By registering for an account on the non-public portions of the LifeBac website or registering to use the LifeBac mobile app (collectively the website and the mobile app, are referred to as the “Platform” despite such definition including the public portion of the LifeBac website for purposes of the Terms of Use and the Privacy Policy), which are both provided to you by LifeBac LLC (“LifeBac”) so that its affiliated or contracted licensed providers (each, a “Provider”) can provide you with telehealth services and consultations related to alcohol use (“Services”), as well as access to a peer support community and educational materials related to alcohol use, you agree to the terms of this Patient Registration Agreement (this “Agreement”). This Agreement is in addition to the Terms of Use and the Privacy Policy

By clicking “I Agree” below, you are completing your registration for access to the Platform and for your receipt of the Services or the receipt of the Services for the individual patient for whom you are the legal representative.  You are further agreeing to be bound by the terms and conditions of this Agreement with LifeBac.  If you do not agree, you should click “I Do Not Agree” and you will not be permitted to access the Platform and complete your registration for the access to the Services.

Make sure to print a copy of this Agreement for your records.  

1. Scope of Medical Care

The Services do not replace your existing relationships with your doctors, but rather, are intended only to supplement those relationships related to your non-emergent alcohol use and dependency needs.

The Services are not available outside the United States and the Services are only available in certain states within the United States.  

2. Solicitation to Request Access and Eligibility Determination

Nothing on the Platform constitutes an "offer" on behalf of LifeBac or the Provider, but is rather an invitation for you to request to access the Services via the Platform. You will be required to submit certain information to LifeBac in order to complete your registration and depending on the information submitted, your eligibility to receive the Services will be determined. Such eligibility may be based on many different factors, including but not limited to your state of residence, current medical conditions or medications, or current alcohol consumption levels. LifeBac does not guarantee the receipt of Services through the Platform even following your full registration. In addition to the initial registration information, LifeBac and/or the Providers may require additional verifications or information before granting any request to access the Services. The information you submit as part of your registration includes certain personally identifiable information as well as your medical history. All information submitted to or collected by LifeBac as part of the registration process, through the Platform, is subject to our Privacy Policy and will only be used or disclosed in accordance with applicable law, including those laws related to the privacy and security of health information related to treatment for alcohol use. You represent that all information you provide as part of the registration process is truthful and accurate.

Once you have submitted all required information as part of the registration process, you will be provided with an appointment with a Provider. This appointment will be free, unless you are otherwise notified that you will be charged for the appointment. The purpose of this initial appointment is to confirm your eligibility to receive the Services through the Platform. The LifeBac solution is inclusive and holistic. If you are eligible to receive the Services, you agree to use the Providers (affiliated and contracted by LifeBac), as well as LifeBac’s contracted pharmacy. Neither LifeBac nor the Providers can guarantee results through your receipt of the Services through the Platform.

All offers set forth on the Platform are void where prohibited.

3. Informed Consent Required

Your use of the Platform is subject to your consent to receive the Services, as set forth in the Informed Consent document.

4. Financial Agreement

By scheduling the appointment with the Provider, you agree that if you are determined to be eligible to receive the Services through the Platform immediately following registration and the first Provider appointment, as described in Section 2 above, the credit card you provided at registration will be billed for your first month’s subscription to receive Services through the Platform. You further agree that thereafter, on the same date each month, your credit card will be billed the monthly subscription fee until you cancel your subscription. For pre-paid 3, 6, and 12 month plans the credit card you provided at registration will be billed for your first 3, 6, or 12 month subscription to receive Services through the Platform. You further agree that thereafter, on the same date each 3, 6, or 12 months, your credit card will be billed the 3, 6, or 12 month subscription fee until you cancel your subscription. The Services can be cancelled at any time upon 5 days’ notice prior to the monthly charge date by calling (888) 959-8858. There will be no partial refunds; once the monthly cancellation date has passed, the subscription payment for that month will not be refunded.

5. User Names and Access

As part of the registration process, you will create a user name and password. You agree that you are responsible for protecting and maintaining the security of your username, password, e-mail address, and other information and materials (the “Registration Information”) and for all uses of and actions taken on the Platform using your Registration Information. Upon registration, you will have the ability to manage your Registration Information, and you agree that you will promptly update your Registration Information as necessary. You are responsible for maintaining access to the e-mail address associated with your account, and you agree that we may be unable to restore access to your account if you lose access to the e-mail address associated with the account. You agree to immediately notify LifeBac of any unauthorized use of your account or any user name assigned to your account and any other breach of security of which you become aware.

6. Use of the Platform

Subject to approval of your request for Platform access and your compliance with this Agreement, LifeBac grants to you a non-exclusive, non-transferable, limited license to access and use the Platform solely for your personal use.  We reserve the right to change, modify, suspend or discontinue any aspect of the Services available, or the Platform in its entirety, at any time without notice.  Further, we reserve the right to terminate your receipt of the Services or access to the Platform at any time and for any reason.  

You have the responsibility for acquiring, installing and maintaining your own technology environment and equipment necessary to properly access, operate and utilize the Platform including, without limitation:  servers, Internet access, LANs and WANs; for any communications or other costs incurred in operating, accessing and using the Platform, and for any other expenses relating to the foregoing.  You are be responsible for ensuring that all computers and devices connecting to the Platform are properly configured, including but not limited to the operating system, web browser, and internet connectivity.

The Health Information provided to LifeBac and the Provider through the Platform by you or that is provided by the Provider to you through the Platform will be maintained as part of the electronic record maintained by LifeBac on behalf of the Provider.  You acknowledge that LifeBac has no responsibility or liability for the health information used or the Services provided by the Providers.  LifeBac may, but has no obligation to, access and review all information and data provided by you for compliance with the terms of this Agreement or otherwise as set forth in the applicable Privacy Policy.

You may elect to provide access to the health information related to the Services to your existing primary care physician or to other third parties.  If you wish for LifeBac to send your health information to your primary care physician or any other third party, you will be required to complete an authorization permitting us to transfer that information.  

You understand that through the Platform, you will have access to an online support community.  You understand that neither LifeBac nor the Providers have an obligation to continuously monitor the activity within the online support communication, and you agree to hold LifeBac and Provider harmless from all activities and communications that occur in the online support community, including those that you might find inappropriate, offensive or harassing. Further, because of the peer interactions within the online community, you may find yourself wanting to spend more time with or to get to know others in the online community in a more social environment.  LifeBac and the Providers strongly discourage this type of knowing social interaction in order to maintain the anonymity.  Other users of the Platform do not have the same legal obligations of privacy and confidentiality as LifeBac and the Providers and anonymity is strongly encouraged.  Further, you shall not disclose your name or contact information to other users through the Platform in the online support community.  [b]LifeBac does not screen or perform background checks on its users and does not vouch for the conduct, intentions, or veracity of other users with whom you may interact in the online support community.  YOU ARE SOLELY RESPONSIBLE FOR YOUR INTERACTIONS WITH OTHER USERS.

7. Your Representations and Warranties

By clicking “I Agree” below, you represent and warrant that (i) you are at least eighteen (18) years of age, (ii) you have the legal ability and authority to enter into this Agreement with LifeBac, (iii) the Registration Information you provided to LifeBac is accurate and complete (iv) you will comply with any and all laws applicable to your use of the Platform, (v) you will not interfere with a third party’s use and enjoyment of the Platform, and (vi) you will not interfere with or disrupt LifeBac’s, the Providers’ or their vendor’s security measures.  If any information you provide to LifeBac becomes inaccurate, incomplete or otherwise false or misleading, you will immediately notify LifeBac.

8. Entire Agreement

This Agreement, along with the Privacy Policy and the Terms of Use constitute the entire agreement between you and LifeBac with respect to the subject matter discussed above.  Any waiver of any provision of this Agreement will be effective only if in writing and signed by LifeBac.  This Agreement supersedes and replaces all prior or contemporaneous understandings or agreements, written or oral, regarding this subject matter.  This Agreement will inure to the benefit of LifeBac’s successors, assigns and licensees.  Print a copy of this Agreement for your records.

9. Nevada State Law Notice to Patient Regarding the Destruction of Health Care Records

Your records will be maintained in accordance with applicable law.  If you are a resident of Nevada, records related to your treatment and services with a Provider may be destroyed after 5 years, unless you would be under the age of 23 years at the time of such destruction.