FISHTOWN MEDICINE - TERMS OF USE & COMMUNICATION CONSENT

These Terms of Use ("Terms") describe your rights and responsibilities when interacting with or receiving care from Fruition Medicine PLLC d/b/a Fishtown Medicine ("Fishtown," "we," "us," "our"). You hereby grant agency authority to any party who clicks on any "I Agree" button or otherwise indicates acceptance to these Terms on your behalf. By creating an account, accessing our site, communicating with us, scheduling care, or receiving services, you agree to these Terms and all referenced policies. We work at the pace of your trust.

1. Eligibility & Licensure Scope

Clinical services are available only to adults (18+) who are physically located in a U.S. state where our clinicians hold an active license at the time of the visit.

2. Consent to Treatment & Telehealth

2.1 General Consent

By receiving services, you consent to diagnosis, treatment, and the use and disclosure of your protected health information ("PHI") for treatment, payment, and healthcare operations as permitted by HIPAA and state law. If you withdraw consent, we must end the care relationship because PHI is required to deliver and document clinical care.

2.2 Telehealth Modalities

Our care is delivered primarily via telehealth — including video visits, audio-only calls, asynchronous messaging, remote monitoring, and other digital tools. You understand the potential risks and benefits. You may refuse or stop telehealth at any time. Home visits, where included as part of a membership tier, are offered subject to clinician availability, scheduling, and geographic feasibility, and are not guaranteed for any specific visit.

2.3 When In-Person Evaluation Is Required

If an in-person exam, procedure, or imaging study is medically necessary, we will direct you to an appropriate local provider.

3. Technology Notice: AI Scribe, Recording, and Observers

3.1 Use of AI Clinical Scribe

We use an AI-enabled clinical scribe during all visits. The scribe processes audio in real time to draft documentation. It does not make diagnoses or determine treatment. A clinician reviews and finalizes all notes. Audio processing can be paused upon request, though pausing may reduce documentation completeness.

3.2 Clinic Recording of Telehealth Visits

We may record audio or video visits for documentation, training, quality improvement, compliance, and fraud prevention. These recordings are PHI and stored securely. External disclosure occurs only with your written authorization or when required by law. Recording may be paused or stopped upon request, but in some cases this may limit our ability to provide or document care.

3.3 Patient Right to Record Visits

You may record any visit for personal use. You may store, replay, or process recordings (including with personal AI tools).

• You are responsible for complying with your state's recording-consent laws.
• If mutual consent is required, you must notify us before recording; continued participation reflects our consent.
• Your personal recordings are not part of your medical record and may lose HIPAA protection once stored outside our systems.

3.4 Use of Personal AI Tools

You may use personal AI tools during visits. These tools are not HIPAA-covered unless you have a separate BAA with the vendor. We are not responsible for the privacy, accuracy, or security practices of your external tools.

3.5 Right to an Observer

You may invite an observer to any visit, including a support person, advocate, trainee, or AI-based observer. Before the visit you must notify us, ensure the observer understands confidentiality, and authorize disclosure of PHI during the visit. Observers may be asked to leave if they interfere with care or compromise safety.

3.6 Required Notice to Observers

Observers must be informed that they may not use or disclose PHI without permission, may not offer clinical advice unless licensed and acting within scope, and may report concerning conduct to the appropriate State Medical Board.

3.7 Effect on the Medical Record

The clinician's finalized documentation is the authoritative medical record. Personal recordings or AI-generated summaries do not modify or replace the official record.

4. Communication Preferences & Consent

4.1 SMS Text Messaging

Opt-in allows us to send non-marketing, care-related text messages that may contain PHI. Standard carrier rates apply. SMS is not encrypted after delivery. Text STOP to opt out.

4.2 Phone Calls & Voicemail

You consent to care-related calls, which may include PHI. You are responsible for protecting your voicemail.

4.3 Email & Secure Portal

Clinical information is primarily sent through our secure portal. If you choose unencrypted email, you accept the associated privacy risks.

5. Website Content Disclaimer

Information on our website or educational materials is general and not a substitute for professional medical judgment or individualized treatment.

6. Privacy Practices

Our HIPAA Notice of Privacy Practices (NPP), available at https://fishtownmedicine.com/about/privacy-policy, describes how we use, disclose, and protect PHI and outlines your rights.

7. Emergencies & Service Limitations

We do not provide emergency services.

• Call 911 or go to the nearest emergency department for any medical or mental-health emergency.
• For mental-health crises, call or text 988.

We may refer you to urgent care or specialists when needed.

8. Financial & Subscription Terms

8.1 Membership Billing

Memberships (monthly, quarterly, or annual) renew automatically at the end of each billing cycle. There are no initiation fees or cancellation fees.

8.2 Cancellation

You may cancel your membership at any time through your billing portal at your account. Upon cancellation, your access continues through the end of the current billing cycle. You will not be charged again after the cycle ends. No partial refunds are issued for unused portions of a billing cycle.

8.3 Packages

Packages are billed as a single payment and renew every 12 months to maintain continuity of care. Package benefits are yours to use once purchased. No partial refunds are issued for packages. You may cancel auto-renewal at any time through your billing portal at your account; cancellation must be completed before the renewal date to stop the next charge. We send a reminder email and SMS approximately 3 days before each renewal.

8.4 Plan Changes

You may upgrade, downgrade, or cancel your plan at any time through your billing portal at your account.

8.5 Chargebacks & Disputes

If you dispute a charge with your bank or credit card company instead of contacting us directly, we reserve the right to suspend services until the dispute is resolved. Please reach out to us first; we will work with you.

8.6 Fee Changes

We may adjust membership or package pricing with at least 30 days' written notice before the change takes effect. Existing billing cycles are honored at the original rate.

8.7 Good-Faith Estimate

Under the No Surprises Act, uninsured or self-pay patients are entitled to a Good-Faith Estimate of expected charges. You may request one at any time by contacting us.

8.8 No Copays, Deductibles, or Coinsurance

We do not bill insurance. All clinical services described in your membership or package are included in your membership fee or package price. You will not receive separate copays, deductibles, or coinsurance charges from us. Services obtained from third-party providers (such as labs, pharmacies, imaging centers, and hospitals) are billed by those providers directly under your insurance or out-of-pocket arrangement with them.

9. Patient Responsibilities

You agree to provide accurate health information, maintain updated contact and payment information, follow agreed care plans, and seek emergency help when advised.

10. Technology Requirements & Security

You must maintain secure devices, updated software, and reliable internet or cellular service. We are not responsible for breaches originating from insecure personal devices. Technology Disclaimer: Our platforms and third-party tools may contain bugs, errors, or service interruptions that could result in loss of data, incorrect records, or delays in diagnosis and treatment. By using the Service, you acknowledge and accept these inherent technological risks.

11. Third-Party Services & Disclosures

Independent labs, imaging centers, pharmacies, EHR vendors, and communication platforms operate under their own terms. BAAs exist for HIPAA-covered vendors. Cookie, tracking-pixel, and accessibility notices are maintained on our website.

11.1 Open Payments Notice

For informational purposes, the federal Centers for Medicare and Medicaid Services (CMS) Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov.

12. Product & Supplement Disclosures

We do not accept compensation for clinical recommendations. Fullscript commissions support platform costs and do not influence clinical judgment.

13. Controlled Substance Policy

• We do not prescribe Schedule II opioids.
• Benzodiazepines and stimulants are prescribed only under strict clinical criteria.

14. Scope of Practice - Services Not Provided

We do not provide obstetric care, neonatal or pediatric care, chronic opioid or benzodiazepine management, transplant care, surgery, or disability determinations.

15. No-Insurance Billing Disclaimer

We do not bill Medicare, Medicaid, or private insurers and do not provide services to Medicare or Medicaid beneficiaries.

16. Data Retention & Destruction

PHI is retained for at least seven years or as required by law, then securely destroyed.

17. Laboratory Products & Results Waiver

Certain services include laboratory testing. You understand that tests can provide false negative, false positive, or inconclusive results. Direct Access Waiver: You hereby elect to exercise your direct right of access to test results under federal law. You knowingly waive any state-specific release delays and affirm your desire to receive testing results as soon as the testing report is complete, even if your provider has not yet reviewed them.

17. Children's Privacy (<16)

Our services and site are not directed to individuals under 16.

18. Right to Decline Care / Patient Termination

We may terminate care with 30-day written notice for non-payment, disruptive behavior, or repeated non-adherence.

19. Indemnification

You agree to indemnify Fishtown Medicine for claims arising from misuse of services or violation of these Terms.

20. Force Majeure

Neither party is liable for delays or interruptions caused by events beyond reasonable control.

21. Feedback License

Suggestions or testimonials may be used to improve services. PHI is never used publicly without permission.

22. Intellectual Property

Site and service content is owned or licensed by Fishtown and may be used only for personal, non-commercial purposes.

23. Disclaimers & Limitation of Liability

Services are provided "as-is" and "as-available." Liability is limited to the amount paid for services giving rise to the claim.

24. Severability & Waiver

Invalid provisions do not affect remaining terms. Non-enforcement of rights is not a waiver.

25. Changes to These Terms

We may update these Terms to reflect legal or operational changes. Continued use constitutes acceptance.

26. Governing Law & Dispute Resolution

These Terms are governed by Pennsylvania law unless federal law applies. Disputes are resolved through binding arbitration in Philadelphia, PA except where prohibited by law.

27. HIPAA Breach Notification & Security Program

We notify affected individuals of any breach of unsecured PHI within 60 days of discovery and maintain a detailed security program consistent with federal requirements.

28. AI-Generated & Automated Content Disclosure

AI tools assist with drafting educational materials and automating reminders. A licensed clinician reviews all patient-specific content before release.

29. Contact Information

Compliance Officer - Fishtown Medicine 2418 E York St, Philadelphia, PA 19125 Phone: (267) 360-7927 Email: compliance@fishtownmedicine.com