Terms of Service

Thank you for your interest in participating in the HIVHealthReform.org Speak Up Project (the “Project”) run by the Center for Health Law and Policy Innovation (the “Center” or “we”, “us” or similar) and the AIDS Foundation of Chicago (the “AFC” or “we”, “us” or similar). We greatly appreciate your participation! To make sure that you understand and consent to our intended uses of the information you provide, we need to obtain your agreement to the terms and conditions described below. These terms and conditions are a binding, legal agreement between you, the Center and AFC.

BEFORE YOU CLICK ON THE “I ACCEPT” BUTTON, CAREFULLY READ THESE TERMS AND CONDITIONS. BY CLICKING ON THE “I ACCEPT” BUTTON OR SUBMITTING INFORMATION TO THE CENTER and AFC IN CONNECTION WITH THE PROJECT IN ANY MANNER, YOU ARE AGREEING TO BE BOUND BY, AND ARE BECOMING A PARTY TO, THESE TERMS AND CONDITIONS. USE OF THIS FORM AND ANY RESPONSES YOU RECEIVE DO NOT AND WILL NOT CREATE AN ATTORNEY-CLIENT RELATIONSHIP OR PHYSICIAN-PATIENT RELATIONSHIP.

TERMS AND CONDITIONS:

INTRODUCTION This comment form (the “Form”) will allow you to submit details about your health care experiences for review, indexing, display and disclosure by the Project. If possible, we need to know the state where you (or your client) live, the insurance company or Medicaid health plan involved, and the kind of issues or problems you (or your client) are experiencing. The more detail the better, but only tell us as much as you (or your client) feel comfortable with. Please do not send us any information that may be used to personally identify you (or your client).

YOUR INFORMATION In connection with the Project, we are requesting information about health care experiences from you and other participants. Your provision of truthful and complete information is extremely important for the purposes of the Project. As a result, you agree that you will provide the Center and AFC with truthful and complete responses to the questions provided to you by the Center and AFC (your “Responses”). Please note that you should not provide any personally identifiable information in connection with your Responses, such as social security number, date of birth, or any other information which might be used to identify you (or your client) in that manner. You are also not required to provide any information such as name, email address, or phone number. However, if it would be okay for us to follow up with you to ask additional questions and learn more, please include an email address or other means of getting in touch with you.

OUR USE OF YOUR RESPONSES You grant us the right to use and disclose your Responses to the federal government, state governments, and/or advocacy organizations for the purposes of the Project and for any other non-commercial or research purpose. Our major goal for this project is to improve access to health care. We will do this by: collecting, cataloging and analyzing problems; reporting them to local, state, and federal officials who are charged with health care reform oversight; and letting the community know about our work to address health care reform problems and concerns. We will also publicly post responses to the issues and concerns raised. In these responses, we may answer questions, provide information on appeals processes and general troubleshooting, and suggest next steps. We will use good faith efforts not to use or disclose any personally identifiable information, but you remain responsible for not providing any such personally identifiable information to us in your Responses. We cannot ensure or warrant the security of any information you provide to us or guarantee that this information may not be accessed, disclosed, altered or destroyed by breach of any of our physical, technical, or managerial safeguards. However, we will not intentionally disclose personally identifiable information.

DISCLAIMER Filling out and/or otherwise using the Form in whole or in part and any responses you may receive via e-mail, phone, or in any other manner do not create or constitute an attorney-client relationship or a physician-patient relationship between you (or your client) and the Center, the AFC, or any affiliated organizations. Any responses you receive from the use of the Form do not represent or communicate legal or medical advice. Any responses you receive represent the opinions and conclusions of its author(s) and not necessarily those of any federal or state agency or private insurer. Before you make any decision that may have legal implications, you (or your client) should consult with a qualified legal professional for specific legal advice tailored to your situation. Before you make any decision related to your health care, you (or your client) should consult with a qualified medical professional for specific advice tailored to your situation.

COPYRIGHT The content, organization, graphics, design, and other matters related to the Form or the responses you receive are protected under applicable copyrights and other proprietary laws, including but not limited to intellectual property laws. The copying, reproduction, use, modification or publication by you of any such matters or any part of the Form or the responses you receive is strictly prohibited, without our express prior written permission.

INDEMNIFICATION You (and your client) agree to indemnify, defend and hold us, our officers, our shareholders, our partners, our attorneys, our employees, our contractors, our affiliates, or any other agents or representatives harmless from any and all liability, loss, damages (whether direct, indirect, special, incidental, punitive or otherwise), claims and expenses, including reasonable attorney's fees, related to your violation of this Agreement or use of the Form.

LIMITATION OF LIABILITY In recognition of the fact that we are conducting this Project for the benefit of the HIV community, you (and your client) agree that under no circumstances shall we or our officers, shareholders, partners, attorneys, employees, contractors, affiliates, or any other agents or representatives be held liable for any loss, damages (whether direct, indirect, special, incidental, punitive or otherwise), claims and expenses, including reasonable attorney’s fees, for our use of information you provide to us, unless we intentionally disclose your personally identifiable information without your consent.

DISPUTES You (and your client) agree that all legal actions or proceedings arising directly or indirectly out of this Agreement or your use of the Form shall be brought exclusively in state or federal courts in either Massachusetts or Illinois. You (and your client) are expressly submitting and consenting in advance to such jurisdiction in any action or proceeding in any of such courts.