Everly Well, Inc.
Consent for Services
Last Modified: November 30, 2021
Introduction
This consent form (“Consent”) reviews the benefits, risks and limitations of you, as the person who has created a user account (referred to as “you” or “your”), utilizing the Services provided by Everly Well, Inc. (referred to as “Everlywell”, “we”, “us” or “our”). It also explains how your information and sample(s) will be used after performance of the Services.
By clicking on the box or sending in your sample, you indicate that this Consent is a binding agreement and that you have read and understood the following terms. Capitalized terms used but not defined in this Consent have the meaning given to them in our other policies.
By clicking on the box or sending in your sample, you have chosen to use our Services and have given your informed consent to have your biological sample(s) tested for biomarkers and to have information related to your use of the Platform and Services shared to your insurance company. This information includes but is not limited to: test results, your contact information, your preferred clinical provider. Biological samples shall consist solely of human fluids and/or tissue samples, depending on the test purchased, that are intended to be analyzed for the individual’s sole use, and not for any other purpose, including but not limited to research, publications, commercial uses, or any other purpose other than to inform the purchaser’s health and/or wellness. For the purpose of clarity, this limitation applies only to individual use and does not apply to Everlywell. Everlywell may use de-identified test results for statistical research studies and publications.
Voluntary Participation
Our Services are offered and available to users who are 18 years of age or older and are residents of the United States. Your use of Everlywell’s Services is voluntary. It is your choice whether to utilize our Services or not. Prior to signing this Consent, you may wish to speak with your insurance company or your healthcare provider for further guidance about our Services.
Procedures and Protocol for Everlywell Tests
When your Account is created, we use some of the information provided by you or on your behalf. We cannot perform the Services without collecting this information, but we will only collect information that will assist us in providing the Services that you have requested. In order for the Services to be provided as intended, you or the party acting on your behalf must provide accurate and correct information. Failure to provide required information or to execute required documents may result in your sample(s) not being tested.
All requests for tests will be reviewed by a licensed doctor (“Health Consultant”) affiliated with a company that we have partnered with to provide review and authorization of testing, review of lab results, and counseling where applicable. Services will not be provided to you if a Health Consultant does not authorize your request and order the applicable test(s). We will refund your insurance company the applicable fees for such canceled tests.
You will collect the biological sample(s) (i.e., blood, stool and urine) that will be provided to and tested by one of our designated testing laboratory partners (“Lab”). You will send the sample(s) directly to the Lab where your sample(s) will be tested for a number of biomarkers.
The results of your test(s) will be made available to you through our Site and will also be mailed to you and your healthcare provider, if applicable. In the event we determine that a biological sample is not suitable for testing due to the content of the sample or because we believe the sample to have been submitted in violation of this Consent or the User Agreement, we reserve the right to withhold the results and to not provide a refund to your insurance company. We will determine and establish normal ranges for all tests in conjunction with our laboratory partners based on their validation and proficiency testing procedures. If your results are clinically significant or have a critical value that falls outside of our established normal ranges by at least a certain amount, a Health Consultant will make reasonable efforts to contact you by telephone.
Benefits
Utilizing our Services to discover what your biomarkers say about you can help you gain a better perspective on your health and how your body functions. You may use this information to make more informed health care decisions and choices. A summary of the potential benefits of our tests is included below.
Product Name |
Potential Benefits Include Learning More Information About: |
HbA1c |
Your body’s ability to control glucose levels. |
Colorectal Cancer Screening Test (FIT) |
Screening for blood in stool which may indicate a risk for colon cancer. |
Microalbumin |
Screening test for anyone who may be at risk for kidney disease or dysfunction |
More information about the specific benefits of our tests and Services are available on our Site.
Risks
In order to utilize our Services, you must collect the appropriate biological sample(s) for the test(s). Some of our tests require a stool sample; there are no risks associated with collecting stool samples using the containers provided in our test kit(s). Some of our tests require the collection of a blood sample. Although the risks and discomforts associated with a blood draw are very low, you might be at risk for excessive bleeding, fainting, feeling light-headed, bruising, hematoma (blood accumulating under the skin), or infection (a slight risk any time the skin is broken). If you have a history of excessive bleeding or fainting while having blood work done, we advise avoiding our tests that require self blood collection.
Disclosing certain information may make you uncomfortable. The results of the tests provided by these Services will be shared with your insurance company, which is covering the cost of the Services. The results of the tests provided by these Services will also be shared with the clinical provider that you designate, if any, during registration. Our Services include biomarker tests that may reveal sensitive information about your health. Everlywell, or the Health Consultant who reviews your results, may advise you to have a follow-up visit with your doctor after reviewing the results of your test. As a result, you may learn about health conditions and problems or potential health risks that you were not aware of before you utilized our Services. You may experience stress, anxiety, or emotional or doctor discomfort when you learn about health problems or potential health problems. The tests may also identify a health risk for a condition that you do not ultimately get diagnosed with, which can lead to stress, anxiety, or emotional or physical discomfort. There may also be additional risks of utilizing our Services that are currently unforeseeable.
Limitations
OUR SERVICES DO NOT PROVIDE MEDICAL ADVICE. The information and content provided, including but not limited to text, graphics, images, videos, and other material contained in the Services, are for informational purposes only and are not intended as a substitute for professional medical advice, help, diagnosis or treatment. Always seek the advice of your doctor or other qualified health care provider with any questions you have regarding your medical care, and never disregard professional medical advice or delay seeking it because of something you have read on or via our Site. Nothing contained in the Services is intended to constitute a medical diagnosis or treatment. Reliance on any information appearing in the Services, including but not limited to information provided by Everlywell or by other users of the Services, is solely at your own risk. By clicking your acceptance, you understand and agree that your results are not intended to be used for any diagnostic purposes and are not a substitute for professional medical advice. You understand that our Services are for information and educational use only; Everlywell does not provide medical services, diagnosis, treatment, or advice.
Everlywell does not warrant the accuracy, completeness, timeliness or usefulness of the opinions, content, services or other information provided through the Services or on the Internet generally. Everlywell and its affiliates, licensors, and suppliers have no control over and accept no responsibility for your compliance with the laws applicable to your state of residence.
Everlywell implements several safeguards to avoid technical errors, but as with all medical tests, there is a chance of a false positive or a false negative result. A false positive result means a biomarker was detected, which is not in fact present. A false negative result means the test failed to identify a biomarker that is in fact present. Other sources of error include sample mix-up, poor sample quality or contamination, and technical errors in the laboratory. Some biological factors, such as a history of bone marrow transplants or recent blood transfusions may limit the accuracy of the results or prevent the Services from being completed.
Science and our knowledge of biomarkers’ meanings are constantly changing. New information may replace or add to the information that we used to interpret your results. We are not obligated to notify you if there is a new understanding of biomarkers that might result in a change to the interpretation of your results. We reserve the right to contact you, at our option, in the future.
Retention and Use of Your Information
We are subject to multiple laws on the retention of data. Accordingly, we retain any information collected about you for as long as we are required to maintain it for regulatory and compliance purposes or for a legal or business necessity.
You will send your biological sample(s) directly to the Lab that will conduct the test. Everlywell has no obligations or liability regarding the retention of your sample(s). You understand that by providing any sample, having your sample processed, accessing your results, or providing information to us, you acquire no rights in any research or commercial products that may be developed by Everlywell or its collaborating partners. You specifically understand that you will not receive compensation for any research or commercial products that include or result from your sample or information.
Your information and test results may be stored in a repository and used for validation, educational, and/or research purposes.
Confidentiality
By sending in your sample or clicking your acceptance of this Consent, you acknowledge that you have read and understand our Privacy Policy and Authorization for Release of PHI. You agree that Everlywell is not liable for the unauthorized release of your results or information unless such unauthorized release was the result of gross negligence or willful misconduct on the part of Everlywell.
Withdrawal of Consent
Your use of Everlywell’s Services is voluntary. You may choose to withdraw your Consent or to stop using Everlywell’s Services at any time. Such requests should be sent to us by email at [email protected] or in writing at Everly Well Inc., 823 Congress Avenue, Suite 1200, Austin, TX 78701.
Please note that while any changes you make will be reflected in our databases within a reasonable period of time, we may retain your information in the ordinary course of business, for the satisfaction of our legal obligations, or where we otherwise reasonably believe that we have a legitimate reason to do so.
Legal Agreement
You give permission for Everlywell, its representatives, affiliates, staff, agents, and designees to perform the requested Services on the sample(s) you provide and to disclose your information and results in accordance with our Privacy Policy and Authorization for Release of PHI. You are not an insurance company or an employer attempting to obtain information about an insured person or an employee.
Contacting Everlywell
If you have questions or comments about our Services or this Consent, please contact us by email at [email protected] by phone at (855) 506-0332, or in writing at Everly Well Inc., 823 Congress Avenue, Suite 1200, Austin, TX 78701.