1. Purpose
This Consent authorizes how MedLocker receives, stores, organizes, processes, displays, and helps you manage information in your account. It is separate from the Patient Directed Records Authorization used to request records from outside record holders and separate from any optional Data Sharing and Monetization Consent.
2. Covered Information
Medical, dental, pharmacy, insurance, claims, billing, lab, imaging, device, wearable, and health app information.
Files, PDFs, images, CCD/CDA documents, XML, JSON, FHIR resources, and other structured or unstructured documents.
Extracted text, structured fields, metadata, timelines, summaries, indexes, tags, and quality review notes generated by MedLocker.
Account, caregiver, representative, consent, sharing, support, technical, security, and usage information associated with your account.
3. Consent to Receive, Store, and Process
I authorize Alpine Labs to receive, collect, store, maintain, and back up information that I provide, upload, connect, or authorize MedLocker to retrieve. I authorize Alpine Labs to convert, extract, parse, normalize, validate, classify, label, structure, and display records; map information to health data standards; create timelines, summaries, indexes, charts, search results, completeness indicators, exports, and consent controls; support customer service; protect security; comply with law; and improve MedLocker.
4. AI Assisted Processing
I understand that MedLocker may use software, machine learning, and AI assisted tools to extract, classify, normalize, summarize, and display my information. These tools may create timelines, interpret document structure, map information to structured formats, generate user facing explanations, and assist support workflows.
AI assisted outputs may be incomplete, inaccurate, or outdated and are not medical advice. Alpine Labs will not use my identifiable health information to train third party foundation models, or permit third party AI vendors to train general purpose models on my identifiable health information, unless I provide explicit opt in consent.
5. HIPAA and Privacy Law Context
I understand that MedLocker is primarily a consumer directed personal health record service. When I direct a HIPAA regulated record holder to send my information to MedLocker, Alpine Labs generally receives the information on my behalf and generally does not receive it as a HIPAA Covered Entity or Business Associate for that consumer directed flow. MedLocker handling of my information is governed by the Privacy Policy, Consumer Health Data Privacy Notice, Terms of Service, this Consent, my other consent choices, the Federal Trade Commission Health Breach Notification Rule where applicable, state consumer health privacy laws, contracts, and other applicable law.
6. What This Consent Does Not Authorize
Selling my identifiable health information to advertisers or data brokers.
Disclosing my identifiable health information to research, life sciences, analytics, data licensing, survey, or clinical trial matching partners without separate opt in consent where required.
Letting third party AI vendors train general purpose models on my identifiable health information without explicit opt in consent.
Providing medical advice, diagnosis, treatment, prescribing, or emergency services.
Sharing my information with caregivers or other recipients unless I choose to share it or another legal basis applies.
7. Sharing, Service Providers, Retention, and Revocation
I may choose to share information with caregivers, family members, personal representatives, providers, or others. Recipients may view, download, copy, screenshot, use, or further disclose it outside MedLocker. Alpine Labs may use service providers for hosting, storage, security, authentication, communications, analytics, payments, support, and infrastructure under confidentiality and security obligations.
I may revoke this Consent or request deletion by using MedLocker controls or contacting privacy@alpinelabs.ai. Revocation may limit or end my ability to use MedLocker and is subject to backup, legal, security, fraud prevention, dispute resolution, audit, and recordkeeping limits.
8. Acknowledgment
By accepting electronically or signing below, I confirm that I have read and understand this Consent, the Privacy Policy, Consumer Health Data Privacy Notice, and Terms of Service. I authorize Alpine Labs to process my information as described above.
Signature
Signature
Printed Name
Date
Representative Name, if applicable