Membership with the Medic Alert Foundation - New Zealand
Incorporated ("MedicAlert®")
is conditional on an individual’s acceptance of the following terms and
conditions (the "Member Statement").
I
acknowledge and agree that:
·
MedicAlert
is an agency under the Health Information Privacy Code 1994
because it provides services in respect of health information.
MedicAlert
will collect, store, use, disclose, and otherwise manage
my personal information and health information (together “my
Personal Health Information”)
in accordance with the Privacy
Act 1993, the Health Information Privacy Code 1994 (as amended from time to
time) and the Health and Disability Commissioner (Code of Health and Disability
Services Consumers' Rights) Regulations 1996;
-
MedicAlert
will create and maintain an electronic record (“File”)
containing my Personal Health
Information that I provide to MedicAlert
or that MedicAlert
collects;
-
MedicAlert
will provide me with: i) a custom engraved MedicAlert
product, ii) access to the 24-hour MedicAlert
Emergency Hotline service; iii) a MedicAlert
Medical Emergency card and iv) secure web-based access
to my File, via ManageMyHealth (collectively the “Services”);
-
MedicAlert
may contact the health care providers whose names I
provide to MedicAlert
for the purpose of collecting my Personal Health Information to assist
MedicAlert
in providing the Services to
me;
-
MedicAlert will collect, use and disclose my Personal Health
Information for the purposes of providing and administering the Services,
including without limitation, disclosing my Personal Health Information to emergency responders and other
health professionals (collectively “Responders”) who contact
MedicAlert, and may disclose my Personal Health
Information to third party service providers retained by MedicAlert to assist it in administering or providing the
Services (including ManageMyHealth), where necessary, for the provision of
the Services;
-
MedicAlert
or Responders may contact the emergency contacts I
have provided for or with information about me in case of an emergency and
MedicAlert
will accept information about
my health from emergency contacts and guardians listed in my File,
provided the contacts and guardians know my member number; full name, date
of birth, and address, but will not disclose my Personal Health Information
to these contacts unless I have instructed otherwise; I will advise
MedicAlert
promptly of any error in, or
whether any update is required of, my Personal Health Information,
MedicAlert
product or wallet card;
-
I will pay any and all service fees
associated with my membership on or before the renewal date of my
membership and I understand that
if I do not pay applicable service fees or have not updated my Personal
Health Information, MedicAlert
will stop providing me with the Services;
-
I
am entitled to access to, and request the correction of, my Personal Health
Information by calling MedicAlert
at 0800 840 111, by logging into my ManageMyHealth
account, or by writing to Membership Services, Medic Alert Foundation NZ,
CBD Towers, Upper Hutt, New Zealand;
-
My
guardian (if I have one), ‘Enduring Power of Attorney – Welfare’ (if I have
one and the power of attorney applies), or any other person that I approve
for this purpose, may access my Personal Health Information via
ManageMyHealth;
-
MedicAlert
requires any clinical information I provide it to be
authenticated by a registered medical professional;
-
MedicAlert
will otherwise use and disclose my Personal Health Information
in accordance with the
MedicAlert Privacy Statement
,
as updated from time to time;
-
Use
of my ManageMyHealth Account will be in accordance with the terms stated
on the ManageMyHealth Website;
-
MedicAlert
, its officers, directors,
employees and representatives, will not be liable for any claims, actions,
damages, losses or consequences of any kind, whether arising from breach
of contract, tort (including negligence) or otherwise, under or in
connection with this Member Statement, the Services, my Personal Health Information
or my File;
-
MedicAlert
may use generalised personal information or health
information, which is not in a form that identifies me or any other
individual, for research projects or studies of interest to the health
care community;
-
I
agree I will be responsible for any fees charged by a health care provider
for disclosing my Personal Health Information to MedicAlert; and
-
Unless
I have indicated otherwise, I agree to receive by e-mail or any other
method of communication chosen by MedicAlert, information such as the
MedicAlert newsletter and information on charitable works, programs and
services that may be of interest to me.