AUTHORIZATION FOR USE AND DISCLOSURE OF HEALTH INFORMATION
Hear.com LLC (“Hear.com”) respects the privacy of its customers. Accordingly, Hear.com seeks your permission to release certain information about you as detailed below. We ask that you carefully review and sign this Authorization.
Section 1 : I voluntarily authorize Hear.com to release solely for the purposes set forth in Section 2 below: some of (a) my contact information (e.g., IP address, Facebook ID, Google ID email address and/or phone number); (b) other information related to products or services I will receive or have received from Hear.com.
Section 2 : I agree that Hear.com may use and disclose the information about me listed in Section 1 above to certain third parties for purposes optimizing and improving marketing messages to me and others.
Section 3 : I understand that I have the right to revoke this Authorization at any time by notifying Hear.com in writing at the address below. Revoking this Authorization will not have any effect on actions that Hear.com took in reliance on the Authorization before it received notice of my revocation.
Section 4 : I understand that if I do not revoke this Authorization, this Authorization will expire one (1) year from the date that I sign it.
Section 5 : I understand that my health information may be protected by law. I understand that Hear.com may be compensated as a result of the release of my health information to third parties for the purposes described in Section 2 above. I understand that the health information that is disclosed under this Authorization may be re-disclosed by the recipient, and no longer protected by federal privacy regulations. However, California law prohibits the recipient from making further disclosure of it, unless another authorization for such disclosure is obtained from me or unless such disclosure is specifically required or permitted by law. I understand that I do not need to sign this Authorization in order to receive products or services from Hear.com. I understand that I may receive a copy of this Authorization if I ask for it in writing addressed to Hear.com’s Privacy Officer at the address listed at the bottom of this page.
Hear.com LLC
Attn: Privacy Officer
396 Alhambra Circle, Suite 600
Coral Gables, Florida 33134
