I acknowledge that I fully understand the risks and limitations of use of electronic communication. I understand that clinic MDCM-GMF, its physicians, and staff, will use reasonable means to protect the security and confidentiality of information sent and received using electronic communication. However, clinic MDCM-GMF, its physicians, and staff cannot guarantee the security and confidentiality of electronic communications.

I acknowledge and understand that it is possible that communications may not be encrypted. I acknowledge and understand that electronic communications can introduce malware, may be forwarded, intercepted, circulated, stored, and even changed without the knowledge or permission of clinic MDCM-GMF, its physicians and staff. Despite this, I agree to communicate using these services with a full understanding of the risk.

While clinic MDCM-GMF, its physicians and staff will attempt to review and respond in a timely fashion, we cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time. The services should not be used for medical emergencies or other time-sensitive matters.

I acknowledge that either I or clinic MDCM-GMF, its physicians and staff, may, at any time, withdraw the option of communicating electronically.