KEYSTONE DIGITAL LIVING WILL

Terms of Use Legal Agreement

We explain everything you need to know to help you understand how
Keystone works; from beginning to end.

Revised as of August 01, 2017

PLEASE CAREFULLY READ THIS IMPORTANT KEYSTONE DIGITAL LIVING WILL TERMS OF USE LEGAL AGREEMENT (“TERMS OF USE”) AS IT WILL GOVERN YOUR RIGHTS AND LIABILITIES REGARDING YOUR USE OF THE SOFTWARE KNOWN AS KEYSTONE DIGITAL LIVING WILL VIA THIS SITE AND THE OTHER CONTENT OF THIS SITE, INCLUDING ALL UPDATES, ENHANCEMENTS AND RELATED MATERIALS PROVIDED TO YOU ON THIS SITE (COLLECTIVELY, “KEYSTONE DIGITAL LIVING WILL”). THESE TERMS OF USE ARE IN ADDITION TO (AND DO NOT LIMIT) ANY OTHER AGREEMENTS YOU MAY HAVE WITH KEYSTONE HEALTHCARE TECHNOLOGIES (HERETOFORE REFERRED TO AS KHT).

THIS LEGAL DOCUMENT IS A BINDING AGREEMENT BETWEEN YOU AND KHT HEALTHCARE TECHNOLOGIES AND/OR ITS AFFILIATES THAT OWN KEYSTONE DIGITAL LIVING WILL  OR PROVIDE THIS WEBSITE OR CONTENT THEREON, AND EACH OF THEIR SUCCESSORS AND ASSIGNS (“KHT”). YOUR USE OF KEYSTONE DIGITAL LIVING WILL INDICATES YOUR ACCEPTANCE OF THESE TERMS OF USE. IF YOU DO NOT AGREE TO THESE TERMS OF USE, YOU MAY NOT USE KEYSTONE DIGITAL LIVING WILL  OR THIS WEBSITE. KHT MAY UPDATE AND CHANGE, AND/OR ASSIGN OR TRANSFER, THESE TERMS OF USE FROM TIME TO TIME WITHOUT NOTICE TO YOU. YOU ARE RESPONSIBLE FOR REVIEWING THESE TERMS OF USE WHEN USING KEYSTONE DIGITAL LIVING WILL , AND KHT IS RELYING UPON YOUR AGREEMENT TO THE TERMS OF USE, AS AMENDED, WHEN PROVIDING KEYSTONE DIGITAL LIVING WILL .

To use KEYSTONE DIGITAL LIVING WILL , you must also be 18 years of age or older and reside in the United States or any of its territories or possessions. This website is for use only by persons located in the United States. KHT makes no claims that the website or any of its content is accessible or appropriate outside of the United States. Access to the website may not be legal by certain persons or in certain countries. If you access the website from outside the United States, you do so on your own initiative and are responsible for compliance with local laws. By using this website, you represent and warrant that you are of legal age to form a binding contract with KHT and meet all of the foregoing eligibility requirements. If you do not meet all of these requirements, you must not access or use the website.

1. License of Software. By accepting these Terms of Use, you may, during the term of these Terms of Use, access the software known as “KEYSTONE DIGITAL LIVING WILL ” over the KEYSTONE DIGITAL LIVING WILL  website (pursuant to any authorization, use and security requirements required by KHT from time to time) when it is available, and use KEYSTONE DIGITAL LIVING WILL  solely for creating a living will / end of life directive pursuant to the KEYSTONE DIGITAL LIVING WILL  documentation supplied via this website for personal non-commercial use. No other use of KEYSTONE DIGITAL LIVING WILL is permitted, including without limitation that under no circumstances may you (i) make KEYSTONE DIGITAL LIVING WILL available, or allow KEYSTONE DIGITAL LIVING WILL to be made available, on a network or file server, or (ii) copy KEYSTONE DIGITAL LIVING WILL, or allow KEYSTONE DIGITAL LIVING WILL to be copied. The rights granted to you under this agreement are non-transferable and non-exclusive and are solely for your own personal non-commercial use. You grant to KHT, and shall acquire from others if necessary, all rights to store confidential and personal information and to use such information as intended by use of KEYSTONE DIGITAL LIVING WILL. You will input information into KEYSTONE DIGITAL LIVING WILL in any method or format required by KHT. You are responsible for your own hardware, software and connectivity required to access KEYSTONE DIGITAL LIVING WILL. You agree that KEYSTONE DIGITAL LIVING WILL will be unavailable at scheduled and unscheduled times.

2. Other Restrictions. (a) You may not rent, disclose, publish, sell, lease, assign, sublicense or otherwise transfer to any third party any of KEYSTONE DIGITAL LIVING WILL or your license rights relating to KEYSTONE DIGITAL LIVING WILL or use KEYSTONE DIGITAL LIVING WILL in any manner not expressly authorized by this agreement. You may not: (i) make any attempt to discover the source code, source files or structure of all or any portion of KEYSTONE DIGITAL LIVING WILL by reverse engineering, decompiling or any other method, or (ii) use the KEYSTONE DIGITAL LIVING WILL in violation of applicable law or in any way which (as determined by KHT) may harm KHT or users of the website or expose either of the foregoing to liability. You also may not attempt to design or create works derived from or based on KEYSTONE DIGITAL LIVING WILL. You may not use any portion of KEYSTONE DIGITAL LIVING WILL to operate a service business or for any other use involving the processing of data of other persons or entities.

(b) You will not export, re-export or transship KEYSTONE DIGITAL LIVING WILL, or any documentation related thereto, or any portion or derivative thereof, outside of the United States without the prior written consent of KHT. You further will not export, re-export, or transship KEYSTONE DIGITAL LIVING WILL, or any documentation related thereto, or any portion or derivative thereof, to any embargoed country so designated by the United States government or to any prohibited individual or entity so identified on the U. S. Treasury Department’s Specially Designated Nationals and Blocked Persons list or any other prohibited list maintained by the U.S. government. You will be solely responsible for complying fully with all applicable export laws and regulations of the United States and any other relevant jurisdiction with respect to your use of KEYSTONE DIGITAL LIVING WILL and this website and will assure that none of KEYSTONE DIGITAL LIVING WILL or any documentation related thereto, or any portion or derivative thereof, is exported, directly or indirectly, in violation of United States law.

3. Term. These Terms of Use are effective until terminated. KHT may terminate these Terms of Use and your access to KEYSTONE DIGITAL LIVING WILL at any time without notice. You may terminate this agreement upon 30 days written notice. This agreement will also terminate if you fail to comply with any term or condition of these Terms of Use or fail to pay any fee due.  You agree, upon any termination, you will cease accessing or using KEYSTONE DIGITAL LIVING WILL, and KHT shall disable your access to KEYSTONE DIGITAL LIVING WILL upon termination. All rights and obligations reasonably intended to survive the termination of these Terms of Use shall so survive (including without limitation the disclaimers and limitations of liability herein).

4. Copyright and Trademark. (a) KHT, and/or its third party providers and licensors, shall at all times retain ownership of all rights, title and interest in and to KEYSTONE DIGITAL LIVING WILL, this website and any copies and parts thereof (including all enhancements, modifications, revisions, updates, supplements, interim works and derivative works thereto, any related technical know-how and all copyright, patent and other intellectual property rights therein). All of the foregoing are protected by copyright and other intellectual property laws. Your rights shall be limited solely to use of KEYSTONE DIGITAL LIVING WILL as provided for herein. You understand that, from time to time, you may provide information regarding KEYSTONE DIGITAL LIVING WILL on which KHT may partly rely to design, structure or develop a modification, improvement, update or enhancement of, or add new functionality to KEYSTONE DIGITAL LIVING WILL (“Developments”). Provided that, as developed, such Developments do not contain any information known by KHT to be confidential information of you, you hereby consent to KHT’s use of such information to design, to structure or to determine the scope of such Developments and acknowledges and agrees that any such Developments shall be, and shall remain, the sole and exclusive property of KHT. You will have no rights, ownership or interest in or to KEYSTONE DIGITAL LIVING WILL except as described herein, and KHT expressly reserves all rights not otherwise specifically granted hereunder. You may not alter or remove any copyright notice or proprietary legend contained in KEYSTONE DIGITAL LIVING WILL or this website. You do not receive any, and KHT retains, all ownership rights in KEYSTONE DIGITAL LIVING WILL and this website.

(b) All trademarks and service marks on this website belong to KHT, except third party trademarks or service marks which are the property of their respective owners.

5. Updates and Support Services. (a) KHT may provide modifications, updates and enhancements (“Updates”) to KEYSTONE DIGITAL LIVING WILL from time to time by directly installing the Update on this website. You agree to only use the Updated KEYSTONE DIGITAL LIVING WILL. You acknowledge that KHT will not be obligated to continue to support or keep active any prior version of KEYSTONE DIGITAL LIVING WILL once an Update is released and active for you. Updates may disable or delete features of KEYSTONE DIGITAL LIVING WILL as necessary, including without limitation due to a change in relationship with a third party licensor or other partner.

(b) Other than the provision of Updates as indicated in Section 5(a), KHT shall not be obligated to provide any support or maintenance services except as may be contracted for in writing for a fee agreed to by KHT. Please refer to KEYSTONE DIGITAL LIVING WILL’s On-Line Help function for certain additional assistance regarding your use of [KEYSTONE DIGITAL LIVING WILL].

6. Warranties and Disclaimers. (a) You represent, warrant and covenant to KHT that:

(i) You are responsible for determining whether KEYSTONE DIGITAL LIVING WILL will achieve the results you desire. You are responsible for adopting reasonable measures to limit your exposure with respect to potential losses and damages arising from use, nonuse, interruption, delay, errors, or omissions of or in KEYSTONE DIGITAL LIVING WILL or Internet or wireless service access, or the results thereof, including (without limitation) examination and confirmation of data prior to use thereof, and provision for identification and correction of errors and omissions.

(ii) You are solely responsible for complying with all applicable international, federal, state and local laws, rules and regulations relating to the use of KEYSTONE DIGITAL LIVING WILL and the information and data related thereto, privacy (including without limitation for sharing information with KHT and putting information on the system), and living wills / end of life directives.

(iii) Your data shall be properly inputted into the system, and no improper or otherwise inappropriate code (such as a virus) shall be inputted into the system.

(b) KEYSTONE DIGITAL LIVING WILL IS PROVIDED TO YOU ON AN “AS IS” AND “WITH ALL FAULTS” BASIS. IN CONNECTION WITH YOUR USE OF KEYSTONE DIGITAL LIVING WILL, YOU MAY BE INSTRUCTED TO OBTAIN AND LOAD ONTO YOUR COMPUTER CERTAIN OTHER THIRD-PARTY SOFTWARE (COLLECTIVELY THE “THIRD-PARTY SOFTWARE”) OR TO CONFIGURE YOUR COMPUTER SYSTEM IN A PARTICULAR MANNER (THE “CONFIGURATION SPECIFICATIONS”). LIKEWISE, KHT PROVIDES THE CONFIGURATION SPECIFICATIONS AND THE THIRD-PARTY SOFTWARE TO YOU ON AN “AS IS” AND “WITH ALL FAULTS” BASIS. YOU ASSUME THE ENTIRE RISK IN USING KEYSTONE DIGITAL LIVING WILL AND THE THIRD-PARTY SOFTWARE AND IN CONFIGURING YOUR COMPUTER SYSTEM IN ACCORDANCE WITH THE CONFIGURATION SPECIFICATIONS. KHT MAKES NO, AND HEREBY DISCLAIMS ANY AND ALL, REPRESENTATIONS AND WARRANTIES THAT KEYSTONE DIGITAL LIVING WILL, THE THIRD-PARTY SOFTWARE OR CONFIGURATION SPECIFICATIONS WILL BE ERROR FREE OR UNINTERRUPTED, OR THAT ANY NON-CONFORMITIES CAN OR WILL BE CORRECTED. KHT HEREBY DISCLAIMS ANY AND ALL REPRESENTATIONS AND WARRANTIES REGARDING OR RELATING TO KEYSTONE DIGITAL LIVING WILL, THE THIRD PARTY SOFTWARE OR THE CONFIGURATION SPECIFICATIONS, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, AND ANY REPRESENTATION OR WARRANTY OF TITLE AND NON-INFRINGEMENT. IN ADDITION, YOU EXPRESSLY AGREE THAT ACCESS TO KEYSTONE DIGITAL LIVING WILL AND THE SITE MAY BE LIMITED OR UNAVAILABLE DURING PERIODS OF PEAK DEMAND, SYSTEM UPGRADES, MALFUNCTIONS, OR SCHEDULED OR UNSCHEDULED MAINTENANCE OR FOR OTHER REASONS. KHT MAKES NO WARRANTIES REGARDING MATERIALS PROVIDED BY THIRD PARTY LICENSORS OR HOSTS, PARTNERS, ARRANGEMENTS WITH THIRD PARTIES, OR USE OF THIRD PARTY SITES, SYSTEMS OR SERVICES.

(c) You understand that KHT cannot and do not guarantee or warrant that files available for downloading from the internet or the website will be free of viruses or other destructive code. You are responsible for implementing sufficient procedures and checkpoints to satisfy your particular requirements for anti-virus protection and accuracy of data input and output, and for maintaining a means external to the site for any reconstruction of any lost data. KHT WILL NOT BE LIABLE FOR ANY LOSS OR DAMAGE CAUSED BY A DISTRIBUTED DENIAL-OF-SERVICE ATTACK, VIRUSES OR OTHER TECHNOLOGICALLY HARMFUL MATERIAL THAT MAY INFECT YOUR COMPUTER EQUIPMENT, COMPUTER PROGRAMS, DATA OR OTHER PROPRIETARY MATERIAL DUE TO YOUR USE OF THE WEBSITE OR ANY SERVICES OR ITEMS OBTAINED THROUGH THE WEBSITE OR TO YOUR DOWNLOADING OF ANY MATERIAL POSTED ON IT, OR ON ANY WEBSITE LINKED TO IT.

(d) THE CONTENT PROVIDED THROUGH KEYSTONE DIGITAL LIVING WILL AND THIS WEBSITE (INCLUDING VIA ANY LINKS ON THIS WEBSITE) MAY BE PROVIDED BY THIRD PARTY CONTENT PROVIDERS AND USERS. KHT IS NOT A PUBLISHER OF SUCH CONTENT AND HAS NO EDITORIAL CONTROL OVER IT. ANY OPINIONS, ADVICE, STATEMENTS, SERVICES, OFFERS OR OTHER INFORMATION GIVEN OR PROVIDED BY THIRD PARTIES ARE THOSE OF THE RESPECTIVE AUTHORS OR DISTRIBUTORS OF SUCH CONTENT AND NOT OF KHT. YOU USE SUCH CONTENT ONLY AT YOUR OWN RISK. In addition, the content on this website is presented only as of the date/time published or indicated, and may be superseded by subsequent events or for other reasons.

(e) KEYSTONE DIGITAL LIVING WILL and this website are not intended to provide tax, legal, insurance or medical advice. You, along with any tax, legal, medical and other counsel you may have, are solely responsible for determining whether the KEYSTONE DIGITAL LIVING WILL, this site, and any product or service, is appropriate or suitable for you and complies with the legal requirements applicable to you.

7. Limitation of Liability. (a) KHT, ITS AFFILIATES AND PROVIDERS SHALL NOT IN ANY CASE BE LIABLE FOR SPECIAL, INCIDENTAL, CONSEQUENTIAL, INDIRECT OR OTHER SIMILAR DAMAGES INCURRED THAT ARISE UNDER OR RELATE IN ANY WAY TO KEYSTONE DIGITAL LIVING WILL, THE WEBSITE OR THIS AGREEMENT, EVEN IF KHT, ITS AFFILIATES OR PROVIDERS HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. IN ADDITION, KHT, ITS AFFILIATES AND PROVIDERS SHALL NOT BE RESPONSIBLE FOR ANY DAMAGES INCURRED AS A RESULT OF LOSS OF USE OF KEYSTONE DIGITAL LIVING WILL, LOSS OR CORRUPTION OF DATA, COSTS OF RECREATING LOST OR CORRUPTED DATA, THE COST OF ANY SUBSTITUTE SOFTWARE, INCURRED COSTS OR EXPENSES, OR FOR OTHER SIMILAR COSTS. THE FOREGOING LIMITATION APPLIES TO ALL CAUSES OF ACTION IN THE AGGREGATE, INCLUDING, WITHOUT LIMITATION, BREACH OF WARRANTY, NEGLIGENCE, STRICT LIABILITY, MISREPRESENTATION AND OTHER TORTS. IN ADDITION, YOU HEREBY ACKNOWLEDGE AND AGREE THAT KHT’S, ITS AFFILIATES AND PROVIDERS MAXIMUM AGGREGATE LIABILITY RELATED TO KEYSTONE DIGITAL LIVING WILL, THIS WEBSITE OR THIS AGREEMENT SHALL IN NO EVENT EXCEED $100.00. SOME STATES IN THE U.S. MAY NOT ALLOW EXCLUSION OR LIMITATION OF IMPLIED WARRANTIES, OR THE EXCLUSION OR LIMITATION OF INCIDENTAL DAMAGES AND THE LIKE, SO THE ABOVE LIMITATION OR EXCLUSION MAY NOT APPLY TO YOU.

(b) KHT AND ITS AFFILIATES WILL NOT BE LIABLE TO YOU OR ANYONE ELSE FOR ANY LOSS RESULTING FROM A CAUSE OVER WHICH KHT DOES NOT HAVE DIRECT CONTROL. THIS INCLUDES FAILURE OF ELECTRONIC OR MECHANICAL EQUIPMENT OR COMMUNICATIONS LINES (INCLUDING TELEPHONE, CABLE AND INTERNET), UNAUTHORIZED ACCESS, VIRUSES, THEFT, CHANGE IN LAW, OPERATOR ERRORS, SEVERE OR EXTRAORDINARY WEATHER (INCLUDING FLOOD, EARTHQUAKE, OR OTHER ACT OF GOD), FIRE, WAR, INSURRECTION, TERRORIST ACT, RIOT, LABOR DISPUTE AND OTHER LABOR PROBLEMS, ACCIDENT, EMERGENCY OR ACTION OF GOVERNMENT.

8. Waiver and Severability. No waiver of by KHT of any term or condition set forth in these Terms of Use shall be deemed a further or continuing waiver of such term or condition or a waiver of any other term or condition, and any failure of KHT to assert a right or provision under these Terms of Use shall not constitute a waiver of such right or provision. If any provision of these Terms of Use is held by a court or other tribunal of competent jurisdiction to be invalid, illegal or unenforceable for any reason, such provision shall be eliminated or limited to the minimum extent such that the remaining provisions will continue in full force and effect and to keep these Terms of Use as close to the original intent as legally permissible.

9. System Use and Security. (a) You assume sole responsibility for the security and integrity of your Internet service and wireless connections, hardware, and all data and information transmitted to, from, or through KEYSTONE DIGITAL LIVING WILL. You agree to provide such security as is necessary to prevent any unauthorized use of KEYSTONE DIGITAL LIVING WILL, including without limitation by implementing a user password policy to restrict access to KEYSTONE DIGITAL LIVING WILL. You shall keep any password and other login requirements confidential and not permit any unauthorized use. In addition, you will immediately notify KHT if any user id/password issued to you in connection herewith is or may be jeopardized, or if any unauthorized access to KEYSTONE DIGITAL LIVING WILL has occurred or is occurring. KHT may change the KEYSTONE DIGITAL LIVING WILL host or other providers at any time, and you shall cooperate with such change (including without limitation with any related changes such as using a new website address for access).

(b) YOU ARE SOLELY RESPONSIBLE FOR ALL USE OF AND ACCESS TO INFORMATION AVAILABLE PURSUANT TO KEYSTONE DIGITAL LIVING WILL, INCLUDING SUCH USE OR ACCESS THROUGH ANY USER ID AND PASSWORD YOU REGISTER FOR. KHT SHALL HAVE NO LIABILITY FOR ANY ACTIONS RESULTING FROM ACCESS TO KEYSTONE DIGITAL LIVING WILL, INCLUDING BY USING SUCH USER ID OR PASSWORD AND YOU AGREE TO INDEMNIFY KHT AND ITS AFFILIATES FOR SUCH ACTIONS TO THE FULLEST EXTENT PERMITTED BY LAW.

10. Indemnification. You agree to indemnify and hold KHT and its affiliates harmless from any claim or demand, including reasonable attorneys’ fees, made by any third party due to or arising out of your use of KEYSTONE DIGITAL LIVING WILL, any content, service or product herein, your connection to this website, your violation of the Terms of Use, or your violation of any rights of another user.

11. Inspection, Correction, and Removal of Information. (a) You agree to provide true, accurate, current and complete information when transmitting and storing information via KEYSTONE DIGITAL LIVING WILL, and KHT is entitled to, and is, expressly relying on the truth, accuracy, currentness and completeness of such information. KHT may archive and store such information. KHT may use such information in any way it deems appropriate. KHT shall be under no obligation to provide any such stored information to you. You agree to provide true, accurate, current and complete contact, registration and other required information when registering for use of KEYSTONE DIGITAL LIVING WILL. You shall maintain and promptly update any such information to keep it accurate. Use of information is addressed in KHT Privacy Policy. KHT cannot require third parties to change information that has been disclosed to them with your consent. To modify this information, you will have to go directly to the relevant third party.

(b) KHT may contact you by email to: (i) provide any notice related hereto; (ii) respond to any questions you may send us; (iii) send you e-mail communications about information we think you will find useful; or (iv) communicate other information as necessary to administer KEYSTONE DIGITAL LIVING WILL. You shall immediately notify KHT upon any change in your e-mail address.

12. Miscellaneous. These Terms of Use and this website’s privacy policy are the exclusive agreement between KHT and you regarding its subject matter. This agreement and your use of KEYSTONE DIGITAL LIVING WILL and this website shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania, without giving effect to conflicts of law provisions. Any suit or proceeding by you arising under or relating to this agreement shall be brought only in a state or federal court sitting in Allegheny County, Pennsylvania. You hereby expressly acknowledge the jurisdiction and proper venue of the foregoing courts in any action or proceeding related hereto. If any provision of these Terms of Use is declared invalid or unenforceable, the remaining provisions of these Terms of Use shall remain in full force and effect. KHT may freely assign or transfer this agreement at any time.

13. Authority. You agree that you have the legal right and ability to agree to these Terms of Use, and that you will use KEYSTONE DIGITAL LIVING WILL in a manner consistent with these Terms of Use. You agree that you are financially responsible for your use of KEYSTONE DIGITAL LIVING WILL.

14. HIPAA Client Sign Off. Clients must sign off on the following Terms and Conditions. As part of your enrollment in The Keystone Digital Living Will, Keystone Healthcare Technologies(KEYSTONE) requires that you (PATIENT) or your representative authorize the use and/or disclosure of certain Protected Health Information (as that term is defined at 45 CFR 164.501) between KEYSTONE and hospitals and other medical treatment centers subject to the United States Federal Health Insurance Portability and Accountability Act of 1996, as amended (HIPAA), or to similar laws outside the United States of America.  Each of these entities is referred to below as a Covered Entity. The PHI may include advance medical directives and other indicators of PATIENT’S medical treatment goals, preferences and priorities (emergency, critical and advance care plans; medical proxies; living wills; do-not-resuscitate orders; and organ donation forms), as well as the PATIENT’S identifying information linking the PATIENT to the PHI and/or information related to the PATIENT’S current and future health care, medical history, treatment, or any other related information.  We may disclose the PHI either directly to the Covered Entity or indirectly across an electronic health record, personal health record, benefits verification, or health information exchange platform in which KEYSTONE participates (these third parties are sometimes referred to as Business Associates under HIPAA). We require your authorization for the use and/or disclosure of such PHI for purposes of permitting KEYSTONE to store and send to the Covered Entities and the Business Associates, as appropriate, and the Covered Entities and Business Associates to provide to KEYSTONE, as well as to locate, retrieve, view and print, such documents and PHI to determine the PATIENT’S medical treatment goals, preferences and priorities in a time of need. By enrolling in The Keystone Life Directive or via Keystone Advance Care Solutions, either directly or with the help of a representative, and using either KeystoneDigitalLivingWill.com, the Keystone Digital Living Will iOS and Android apps, and through Keystone Advance Care Solutions, PATIENT agrees as follows:

(a) PATIENT agrees that KEYSTONE and the Covered Entities and Business Associates may disclose the PATIENT’S PHI to each other only for purposes listed above.

(b) Once the information above is released, the information may be subject to re-disclosure by KEYSTONE or a Covered Entity or Business Associate and may not be protected under the privacy rules promulgated under HIPAA or similar laws outside the United States of America.

(c) The Covered Entity or the Business Associate, as appropriate, will provide PATIENT with a copy of the PHI for which this authorization is being sought upon the written request of PATIENT.

(d) The Covered Entity may not condition treatment, payment, enrollment, or eligibility for benefits (as applicable) on whether the PATIENT signs this authorization.

(e) PATIENT is voluntarily agreeing to and digitally signing this authorization.

(f) PATIENT may print a copy of the signed authorization or request a copy from KEYSTONE.

(g) This authorization will remain in effect until it is revoked by the Patient and no further use or disclosure of PATIENT’S PHI is permitted to any Covered Entity or Business Associate beyond that date.

(h) PATIENT has the right to revoke this authorization at any time. The revocation must be in writing, and submitted to the following address: Keystone Healthcare Technologies, P.O. Box 6247, Harrisburg, 17112 PA  United States of America.

(i) Once this authorization is revoked, KEYSTONE, the Covered Entities and the Business Associates will not use or disclose the PHI for the above-stated purpose except to the extent that KEYSTONE or a Covered Entity or Business Associate has already relied on the authorization.