Access Foxhall Terms and Conditions

In consideration of the Annual Membership Fee, FHM agrees to provide the Patient with the following services:

• 24-hour Direct Access to your physician through a dedicated email address and phone number.
• Priority Appointment Scheduling.
• Facilitated Scheduling for testing, outside appointments, and specialist referrals.
• Priority Prescription Refills.
• Facilitation of prior authorization for medications and medical testing as insurance requires.
• Collection and processing of medical records from other providers and facilities.
• Liaising with outside providers for patients with complex issues and all other administrative needs.

Membership will renew automatically each year unless a written cancellation request is received.

Health Care Services Excluded from Membership Fee

The annual fee covers the cost of the Program Services; however, the fee does not cover the cost of any healthcare services provided by Dr. Joshua S.
Yamamoto or Dr. Kristin E. Thomas-Yamamoto. All visits and medical services will be billed to insurance and must be paid for at the time of service. Neither Physician nor Practice makes any representations whatsoever that any fees paid under this Agreement are covered by the Patient’s health insurance or other third-party payment plans applicable to the Patient. Nothing in this Agreement Supersedes or modifies the terms or conditions of any agreements related to your health insurance. The patient acknowledges that he/she is financially responsible for any health care services received, and payment is expected at the time of service.

Term and Termination

Unless earlier terminated as set forth below, the initial term of the Agreement shall be for one year, commencing on the Effective Date and renewing annually on the first anniversary of the
Enrollment Date. Either party may decline to renew the agreement upon written notification to the other party no less than 30 days before the expiration of the Initial Year or the Renewal Year, as applicable.

The Agreement may be terminated as follows:
• The patient may terminate this Agreement at any time upon thirty (30) days prior written notice to the Practice. The patient will not be entitled to refund the Membership Fee or a portion thereof.

• Patient may terminate this Agreement immediately upon relocation to a new locality outside the area of the Practice and Physician.

• This Agreement automatically terminates upon the death or dissolution of the other Party.

Communications

The patient authorizes the Physician, Practice staff, and designees to communicate with the Patient by e-mail regarding the Patient’s protected health information (“PHI” as defined in the Health
Insurance Portability and Accountability Act of 1996 and its implementing regulations) via the Patient’s cell phone and/or email address shown on this Agreement. Additionally, Patients can communicate with the Practice via email regarding test results or any other non-urgent medical issues. Email responses will typically be within 24 hours and no later than within two business days. Electronic Communication includes but is not limited to email, text (SMS, MMS, Instant Messaging), and audio or video conference.

The patient acknowledges and agrees that:
• Electronic Communication may not be secure for sending or receiving PHI.

• Although the Physician and Practice staff will make reasonable efforts to keep Electronic Communication with the Patient confidential and secure. The Patient understands that they cannot
assure or guarantee the confidentiality of Electronic Communication.

• All Electronic Communication is part of the Patient’s permanent medical record.

• The patient will not use Electronic Communication for communications regarding emergencies,
urgent medical problems, or other time-sensitive issues. In the event of an emergency or a situation
that the Patient could reasonably expect to develop into an emergency, the Patient shall call 911 or
proceed to the nearest emergency facility and follow the directions of emergency personnel.

• Neither the Physician nor any of the Practice’s agents, consultants, or representatives will be liable to
the Patient for any loss, damage, cost, injury, or expense caused by or resulting from (1) a delay in
response to Patients due to technical failures, including but not limited to technical failures attributable
to the internet service provider, power outages, failure of electronic messaging software, failure by
Physician, or any of Practice’s agents, consultants, or representatives to adequately address Electronic
Communication messages, failure of computers or computer networks, or faulty telephone or cable
data transmission; (2) any interception of Electronic Communication by a third party; or (3) the
Patient’s failure to comply with the guidelines regarding the use of Electronic Communication
outlined in this Section.

Amendment

The Agreement contains the parties’ entire agreement and supersedes all prior agreements and understandings between the Parties regarding the subject matter. The Agreement may only be amended by a written agreement signed by the Parties. Notwithstanding the foregoing, the Practice may amend this Agreement to the extent required by federal, state, or local law, rule, or regulation by sending the Patient thirty-day (30) advanced written notice of any such change. Any such changes are incorporated by reference into this Agreement without the need for signature by the parties and are effective as of the date established by the Practice, except that the Patient shall initial any such change at the Practice’s request.

Assignment

The patient may not assign the Agreement to another individual.

Entire Agreement

This Agreement contains the whole agreement between the parties and supersedes all
prior oral and/or written understandings and agreements regarding the subject matter of this agreement.