Terms Of Service
By submitting the medical request form and completing payment, you, the "Requester," acknowledge and agree to the following terms:
1. Provision of Records
* Morgan Records Management, LLC ("MRM") will provide you with copies of all records on file unless specific portions are excluded as directed by the original provider or required by applicable state and federal laws.
* All records will be provided in a readable format that does not require proprietary software to view or access.
2. Compliance with Laws
* Record requests will be fulfilled in accordance with all applicable state and federal laws, including but not limited to the Health Insurance Portability and Accountability Act (HIPAA).
* State laws governing the release of records will apply based on the state where the records were originally generated.
3. Delivery of Records
* Copies will be delivered using the HIPAA-compliant delivery method selected by the Requester.
4. Payment Terms
* Full payment is required at the time of submission using the payment method provided on this form.
* All fees are non-refundable once processing begins, even if the Requester cancels the request.
* Payments will be refunded only if MRM does not have any records on file for the Requester.
5. Authorization and Identity Verification
* Requesters must provide a valid government-issued photo ID or legal documentation to confirm their identity and/or authorization.
* Patients over the age of 18 must sign the release form for the request to be processed.
* For patients under the age of 18, a legal guardian must sign the release form on their behalf and provide supporting documentation proving legal guardianship.
6. Authorization Confirmation
By submitting this form, you confirm and agree:
* You are the patient or legal guardian authorized to release the requested records.
* A facsimile, copy, or photocopy of this release is valid for 90 days and authorizes the release of medical records.
* This authorization permits MRM to release only records from the specified facility. Records from other providers must be obtained directly from them.
* Records released under this authorization may include sensitive information (e.g., drug-related conditions, psychological conditions, infectious diseases) subject to additional federal and state restrictions.
* Information disclosed may be re-disclosed by the recipient if they are not a covered entity under federal privacy laws, and such information may no longer be protected.
7. Processing Timeline
* Requests will be processed in the order they are received. Records will be delivered within 30 business days or as required by state and federal laws governing record fulfillment.
8. Scope of Authorization
* This authorization is valid only for the release of medical records explicitly requested on this form.
* This release does not authorize any further use, disclosure, or transfer of records beyond the stated purpose.
9. Requester Acknowledgements
* You acknowledge that incomplete or incorrect information on the request form may result in delays or inability to process the request.
* MRM is not responsible for delays caused by incomplete forms, missing documentation, or incorrect contact information provided by the Requester.
* You agree to indemnify and hold MRM harmless against any claims, damages, or liability arising from the improper use or unauthorized disclosure of records after they have been delivered.
10. Data Security and Privacy
* MRM takes all reasonable precautions to ensure the secure handling, transfer, and delivery of records in compliance with HIPAA.
* The Requester agrees to ensure the security and confidentiality of records upon receipt.
11. Limitation of Liability
* MRM shall not be liable for any delays, errors, or omissions in processing record requests caused by factors outside its control, including but not limited to third-party errors, legal restrictions, or technical issues.
* MRM is not responsible for any misuse of records after delivery to the Requester.
12. Electronic Signature and Agreement
* By submitting this form electronically, you acknowledge that your electronic submission constitutes your signature and agreement to the terms and conditions stated herein.
13. Governing Law
* This agreement is governed by and shall be construed in accordance with the laws of the state where the records were generated.
* By completing and submitting this form, you affirm that you have read, understood, and agreed to these terms.
Thank you for choosing Morgan Records Management!