The term "Provider" includes Centre for Sight and all medical and administrative staff thereof.

1. RISKS OF USING EMAIL
The provider offers patients the opportunity to communicate via email. However, transmitting patient information by emailhas a number of risks that patients should consider before using email. These include but are not limited to the following risk:

1.1. Email can be circulated, forwarded and stored in numerous pages and electronic files.
1.2. Email can be immediately broadcast worldwide and may be received by many intended and unintended recipients.
1.3. Email senders can easily misaddress an email.
1.4. Email is easier to falsify than handwritten or signed documents.
1.5. Back-up copies of email may exist even after the sender of the recipients has deleted his or her copy.
1.6. Employers and on-line services have a right to archive and inspect emails transmitted through their systems.
1.7. Email can be intercepted, altered, forwarded or used without authorisation or detection.
1.8. Email can be used to introduce viruses into computer systems.
1.9. Email can be used as evidence in court.

2. CONDITIONS OF USE OF EMAIL
The provider will use reasonable means to protect the security and confidentiality of email information sent and received. However, because of the risks outlined above, the provider cannot guarantee the security and confidentiality of email communication, and will not be liable for improper disclosure of confidential information that is not caused by the provider's intentional misconduct. Thus, patients must consent to the use of email for patient information. Consent to the use of email includes agreement with the following conditions:

2.1. All emails to or from the patient concerning diagnosis or treatment will be printed out and made part of the patient's medical records. Other individuals authorized to access the medical records, such as staff and billing personnel, will have access to those emails.
2.2. The provider may forward emails internally to the provider's staff and agents as necessary for diagnosis, treatment, reimbursement and other handling. The provider will not, however, forward emails to independent third parties without the patient's prior written consent, except at authorized or as required by law.
2.3. Although the provider will endeavour to read and respond promptly to an email from the patient, the provider cannot guarantee that any particular email will be read and responded to within any particular period of time. Thus, that patient shall not use email for medical emergencies or other time sensitive matters.
2.4. If the patient's email requires or invites a response from the provider, and the patient has not received a response within a reasonable time period, it is the patient's responsibility to follow-up to determine whether the intended recipient received the email and when the recipient will respond.
2.5. The patient should not use email for communication regarding sensitive medical information, sic as information regarding sexually transmitted diseases, AIDS/HIV, mental health, developmental disability or substance abuse.
2.6. The patient is responsible for informing the provider of any types of information the patient does not want to be sent by email, in addition to those set out in 2.e. above
2.7. The patient is responsible for protecting his/her password or other means of access to email. The provider is not liable for breaches of confidentiality caused by the patient or any other third party.
2.8. The provider shall not engage in email communication that is unlawful.
2.9. It is the patient's responsibility to follow-up and/or schedule an appointment if warranted.

3. INSTRUCTIONS
To communicate by email, the patient shall:

3.1. Limit or avoid use of his/her employer's computer.
3.2. Inform the provider to any changes to his/her email address.
3.3. Put the patient's name in the body of the email.
3.4. Include the category of the communication in the email's subject line, for routing purposes (e.g. billing query).
3.5. Review the email to make sure it is clear and that all relevant information is provided before sending to the provider.
3.6. Inform the provider that that patient received an email from the provider.
3.7. Take precautions to preserve the confidentiality of emails, such as using screen savers and safeguarding his/her computer password.
3.8. Withdraw consent only by email or written communication to the provider.

4. PATIENT ACKNOWLEDGEMENT AND AGREEMENT
I acknowledge that I have read and duly understand this consent form. I understand the risks associated with the communication of email between the provider and myself, and consent to the conditions outlined above. In addition, I agree to these instructions, as well as any other instructions that the provider may impose to communicate with patients by email. Any questions I had were answered.