Release of Personal Health Information(PHI)

DISCLAIMER

This disclaimer applies to all individuals participating in assessments provided by SeniorLife.AI, referred to as “Test Persons” or “patients”. It must be communicated to the Test Person by the administrator of the assessment, known as the “Tester”. In case one uses the service as a patient, the Test Person and the Tester may be the same person.

The Test Person is not required to sign any release form, but by using the services of SeniorLife.AI by self or via a Tester, the Test Person agrees to disclose certain protected information to the specified recipients as described herein. There is a potential for information disclosed under this authorization to be re-disclosed by the recipient and no longer protected by federal privacy regulations.

INFORMATION COLLECTED

A Test Person taking an assessment using SeniorLife.AI services may provide the following information:

Required Information

• Test Person ID: This is necessary to uniquely identify the Test Person. It can be a Patient ID, Insurance ID, or any other unique identifier.
• Video data: As instructed in the specific assessment module, video data is required.

Recommended Information

• Age: Providing age information helps the software make better decisions regarding recommended actions.
• Gender: Gender information also assists the software in making more accurate recommendations.

Optional Information

• Test Person’s First Name: This can be entered voluntarily.
• Test Person’s Last Name: This can also be entered voluntarily.

INFORMATION GENERATED

Our software analyzes the video data, generates a report and provides recommendations to address potential problems as suggested by our analysis. Our software also tracks history and trend of the assessments over time.

INFORMATION RECIPIENTS

SeniorLife.AI does NOT share any information with a third party. Only users can initiate sharing of information. By default, our test results and reports include ALL the information entered by the Tester.