Information and Acknowledgment Form

PLEASE READ THE FOLLOWING INFORMATION CAREFULLY. YOUR USE OF THE PATIENT EMAIL SERVICE WILL INDICATE YOUR UNDERSTANDING OF THIS INFORMATION, YOUR AGREEMENT THAT YOU WILL FOLLOW ALL INSTRUCTIONS GIVEN, AND YOUR ACCEPTANCE OF THE RISKS AND TERMS OUTLINED BELOW. IF YOU DO NOT AGREE TO BE BOUND BY THESE TERMS, PLEASE DO NOT USE THIS SERVICE.

Risks of Using Electronic Communication Systems, Including Email

FHN offers patients the opportunity to receive certain notifications and greetings by email. FHN uses industry-standard technologies to protect and secure the www.fhn.org website, including the patient email service.

However, the use of any electronic communication system, such as the World Wide Web, for email communications has a number of risks that users should consider before use. Many of these risks apply to the use of electronic information in general; other risks apply particularly to email communications. These include, but are not limited to, the following risks:

  • Electronic communications, including email, may be copied, circulated, forwarded and stored in numerous paper and electronic files
  • Electronic communications, including email, may be accidentally, intentionally, or unintentionally broadcast worldwide and received by many unintended recipients
  • Electronic communications, including email, are easier to falsify than handwritten or signed documents
  • Backup copies of electronic communications, including email, may exist even after the originator or recipient has deleted his or her own copy
  • Employers and online services have a right to archive and inspect emails transmitted through their systems
  • Electronic communications, including email, are discoverable and can be used as evidence in court
  • Email senders can easily misaddress an email
  • Email can be intercepted, altered, forwarded or used without written authorization or detection
  • Email can be used to introduce viruses into computer systems
  • Electronic communications, including email, may be misinterpreted
  • Electronic communications, including email, may not be received in the time frame expected by the sender

FHN will use reasonable means to protect the security and confidentiality of electronic information sent and received, including the use of encryption and other security technologies. However, because of the risks outlined above, FHN cannot guarantee the security and confidentiality of Web-based communications, and will not be liable for improper disclosure of confidential information that is not caused by intentional misconduct on the part of FHN.

Thus, you must agree to and acknowledge the following terms before using the patient email service on www.fhn.org as a means to attempt communication with a person or persons believed to be a patient at our facility. You also agree that FHN has no obligation to confirm receipt or delivery of the message, and because of strict privacy practices, will not, and cannot, confirm if a specific person is a patient at our facility. Please refer to our privacy practices policy for more information regarding use and disclosure of medical information.

I understand that electronic communications will be responded to as promptly as possible; however, a specific turnaround time or delivery to the intended recipient is not guaranteed. I also understand that the message I send is not private. Thus, I will not use electronic communications to relay personal information or time-sensitive matters.

I acknowledge that FHN may discontinue this service at any time.

Acknowledgement and Agreement

By sending a message using this service, I acknowledge that I have read and fully understand the information provided in this form. I understand the risks associated with using electronic systems to contact a patient at FHN. I agree to the terms listed above, in addition to the terms and conditions of the Privacy Notice on this Web site.

In addition, I agree to the instructions outlined herein, that my email may or may not be received or delivered and cannot be responded to, that FHN cannot confirm a patient's presence at FHN or provide any information relating to his or her condition. I understand that FHN may discontinue this service at any time for any reason. Any questions I may have had were answered prior to my use of this service.