Service Agreement  

Eligibility Requirements

In order to qualify for Prescription Services, the following must be true:

• You are eighteen (18) to fifty-five (55) years of age.
• You meet our medical criteria and do not have a history of diabetes, glaucoma, cataracts, retinal detachment, brain injuries, neurological issues; symptoms of acute eye pain; or flashes and floaters in your eyes.
• You are currently located in a State or territory where we provide services.
  You are able to follow text or audio instructions; stand and physically move forward or backward from your computer screen; and cover one eye while operating a web-enabled phone.
• Your refractive error, if any, falls into the following categories:
  • Emmetropic
  • Myopic with spherical power between “-0.25 and -12.00”
  • Hyperopic with spherical power between “+0.25 and + 6.0 “
  • Astigmatic with cylinder power between Cyl “-0.25 and -5.00”
  • Presbyopic with ADD power between “+0.25 and +4.00”

In addition to the above requirements, Todd Smith reserves the right to change or include new requirements as deemed appropriate in its sole discretion without providing additional notice.

Our Services

Todd Smith provides healthcare services, including Prescription Services, through the use of the internet, mobile browser applications, and other interactive electronic communication technologies. Your Todd Smith healthcare professional will be licensed to practice in his/her specialty in the State or territory where you are located, but the professional will be performing all evaluations remotely through the use of these electronic technologies. In your State, Todd Smith’s services may be considered telehealth or telemedicine.
Todd Smith reserves the right to deny services to anyone in its sole discretion, except as prohibited by law.

Under this Agreement, Todd Smith agrees to provide the following healthcare and related services (“Services”):

• Todd Smith will provide: (1) access to its technology for you to self-administer a visual acuity test through use of the internet, and (2) the results of your eye test(s) (your renewed prescription or whether you should see a doctor in person, if appropriate).
• Unless you are determined to be ineligible, or fail to provide Todd Smith with a prior prescription or any requested relevant information, Todd Smith will provide a licensed healthcare professional qualified to practice medicine or ophthalmology in your state to evaluate the results of your tests, your prior prescription, and your medical history , and issue a vision or ocular prescription, including a prescription for corrective eyewear, if clinically necessary (“Prescription Services”).
• Todd Smith may share your service status and vision and ocular prescription with a qualified optician or retailer that you have engaged to dispense glasses or contacts, or to a qualified optician or retailer that directed you to Todd Smith via a custom link or Application Programming Interface (API).
  Todd Smith may verify your most recent vision and ocular prescription with the healthcare provider that issued it.
• Todd Smith may use the information you provide (including your medical information) to present special offers to you from Todd Smith or 3rd party vendors.
• Todd Smith will provide educational and related information on eye health.
• Todd Smith will provide a non-comprehensive list of available resources for you to receive an eye health exam and obtain corrective eyewear.
• Todd Smith does not perform a comprehensive eye exam to measure your eye health. Our vision test only measures your visual acuity.
• Todd Smith will not provide any services for medical emergencies or urgent situations.

Your Responsibilities and Acknowledgements

• You agree that the Services will be used only for you, and that the identification information you have provided is accurate and truthful.
• You shall be responsible for providing accurate health, demographic, geographic and contact information.
• You agree to strictly follow all of the instructions provided by Todd Smith in your self-administration of the vision test.
• You understand that Todd Smith’s Services DO NOT include a comprehensive eye health examination.
• You agree to visit an optometrist or ophthalmologist at least every two (2) years to get a comprehensive eye health examination.
• You agree to follow the recommendations of Todd Smith’s licensed healthcare professionals, who may recommend more frequent visits.
• You agree to update your contact information within two (2) days of any change.
• You agree to pay or be responsible for payment of the cost of the Services in accordance with this Agreement and Todd Smith’s policies, as it may be changed from time to time.
• You understand and agree that Todd Smith may use your de-identified health information to perform research to improve the accuracy and efficacy of our technology.
• If asked, you agree to provide your most recent glasses or contact lens prescription and the contact information of the healthcare provider that issued the prescriptions.
• If asked, you agree to retake the Todd Smith Online Vision Test again in part or in whole.
• You give Todd Smith permission to contact your healthcare provider to verify your prior glasses or contacts prescription on your behalf.

Service Acceptance and Informed Consent

You have the legal right and ability to and agree to: (i) enter into this Agreement, (ii) use the Services for your personal benefit, and (iii) abide by the obligations in the Agreement. You acknowledge that you understand that Todd Smith’s Services are provided through the use of electronic technology. You further acknowledge that you understand that the Todd Smith healthcare professional will NOT be in the same physical location as you at the time the Services are performed. Providing healthcare services through the use of electronic technology and the remote participation of healthcare professionals may be considered telehealth or telemedicine. Among others, the benefits of receiving healthcare services in this manner include improved access to healthcare professionals, convenience, and reduced cost.

As with any medical or health service, there are potential risks associated with the use of services through the use of electronic technology, including but not limited to:

• The information transmitted may not be sufficient to allow the healthcare professional to make an appropriate clinical decision.
• Delays in transmission, evaluation or treatment due to equipment or connectivity failure.
• Lack of access to your full medical history and/or condition due to the remote location of the healthcare professional.
• Breach of privacy of personal information due to a failure of security systems or protocols.

Todd Smith’s vision test, like an in-person eye refraction examination, is not perfect or absolute. You understand that while the Todd Smith vision test is designed to assess visual acuity, which shall be limited specifically to near sighted/myopia, far sighted/hyperopia, astigmatism, presbyopia, emmetropia, or any combination of these, the vision test process is not perfect or absolute. As explained in greater detail on our website, www.telehealthaffiliate.com (“Site”), there is a statistical possibility that a vision test may yield an inaccurate evaluation, which may result in the generation of uncomfortable or inaccurate corrective eyewear and the need for a patient to retake the vision test. An uncomfortable or inaccurate corrective eyewear prescription may cause eye strain, headaches, blurry vision, double vision, or overall general eye pain. You understand that if you experience any of the described adverse effects, you will immediately (a) remove the glasses or contacts causing this issue, (b) contact us at [email protected], and (c) follow any recommendations we provide you for seeking additional care.  

You acknowledge and agree that you are making an informed decision to use the Services, and have been given all necessary and relevant information to make that decision. By entering into this Agreement and/or accepting the Services, you agree that:

• You are a patient of Todd Smith and are entering into a patient-provider relationship with the healthcare professional assigned to you by Optimized Eye Care, P.C.
• You may expect the anticipated benefits from the use of Todd Smith’s Services, but no results can be guaranteed or assured.
• You could receive similar services from a local healthcare provider, but you are choosing to receive these services from Todd Smith through the use of electronic technology and a remote healthcare professional.
• You are giving permission for Todd Smith to send your service status and vision and ocular prescription to a qualified healthcare provider or retailer with appropriate authorization.
• You are giving permission for Todd Smith to share your service status and vision and ocular prescription with a qualified healthcare provider or retailer that you have engaged to dispense glasses or contacts.
• You are giving permission for Todd Smith to share your service status and vision and ocular prescription with a 3rd party that you designate or to a qualified optician or retailer that directed you to Todd Smith via a custom link.
• You are giving permission for Todd Smith to send your contact information, service status and vision and ocular prescription to a qualified retailer with appropriate authorization.
• You are giving permission for Todd Smith to record voice and sound via your device for the purposes of providing the Todd Smith Online Vision Test. Your responses may be transcribed into text, which may be stored securely with the rest of your test data.
• You agree to receive email and text communications from Todd Smith based on your health information that may contain commercial advertisements or promotions for services or products from Todd Smith or a 3rd party with whom Todd Smith has a financial relationship and may benefit from your purchase of the service or product.
• You are giving permission (consent) to Todd Smith, and specifically Optimized Eye Care, P.C., to provide a vision acuity assessment and/or screening, evaluate the results, and issue you a vision or ocular prescription, including a prescription for corrective eyewear, if clinically necessary.
• If you obtain a prescription for corrective eyewear, you agree that it is solely for your personal use. 

You agree to fully and carefully read all provided product information and labels and to contact us or a local optometrist or ophthalmologist if you have any questions regarding the prescription.

Privacy and Security

Todd Smith respects your privacy and takes privacy very seriously. By accepting this Agreement, you consent to Todd Smith’s use and disclosure of your personally identifiable information, including health information, provided to us or developed while receiving Services as outlined in our Privacy Policy and Notice of Privacy Practices, which are part of the Agreement.

Information that you provide to us or that we collect about you through your access to and use of the Site is subject to our Privacy Policy, and any health information collected about you will be governed by our Notice of Privacy Practices. We encourage you to read and become familiar with our Privacy Policy.

Electronic Health Record

Todd Smith maintains an Electronic Health Record (“EHR”) system and creates a record for each patient as part of your online account (“Patient Chart”). Your Patient Chart is created to store your personally identifiable information, including your health conditions and other Personal Health Information (“PHI”). Information provided as part of the Todd Smith registration process or your communication with an Todd Smith representative may, if appropriate, be maintained in your Patient Chart and relied on by our healthcare professionals in providing our Services. You agree to provide accurate information, review the information in your Patient Chart, and to update such information, as needed.

You may request your Patient Chart for four years or the period required by State or Federal law, whichever is longer. For additional information regarding use of your Patient Chart and your rights relating to PHI and other health information we collect or maintain about you, please see our Privacy Policy and Notice of Privacy Practices.

Public Health Reporting

Todd Smith may be required by law to disclose certain health information to federal and/or state public health agencies to report, prevent, or control disease, injury or disability. Todd Smith may or may not provide you notice of our compliance with these legal requirements.

Payment of Fees and Cancellation Policy

Todd Smith will accept payment for Services in the following manner:

• From you.
• From other sources authorized by you to make a payment to Todd Smith on your behalf, including, but not limited to other healthcare professionals, retail eyewear providers, etc.
• From your health insurance plan (“Plan”), if Todd Smith has a contract or other arrangement with your plan. If Todd Smith does not have a contract or other arrangement with your Plan, you will be responsible for paying Todd Smith directly.

Todd Smith accepts various forms of electronic payment in accordance with Todd Smith policies and this Agreement. Todd Smith currently accepts electronic payments made by credit or debit card, pre-paid cards such as gift cards or health-savings accounts.

Todd Smith is subject to complex laws and regulations that are constantly evolving and vary from state to state. Specific billing practices and service availability may be amended periodically to comply with changes in the law or guidance from Plans and regulatory authorities.

If you direct Todd Smith to accept payment for your Services from another eligible source, Todd Smith will accept payment in accordance with a separate agreement or understanding between Todd Smith and the eligible source. Todd Smith will not initiate Services until payment is received or arranged to be received from the eligible source.

If you choose to use your Plan for payment, Todd Smith will initially charge your credit, debit or other source for the cost of your Services and submit a claim to your Plan in accordance with your Plan’s requirements. You agree to pay any necessary co-pays or deductibles as required by your Plan. Once Todd Smith receives payment from your Plan, Todd Smith will credit your card in the amount received. If your Plan denies coverage for any Services, Todd Smith will retain the amount initially charged to your card as payment in full.

You can cancel or change your request for services at any time prior to submitting your order for purchase of our Services. Once an order for Services has been submitted for purchase, you will be responsible for full payment of the Services, even if you do not receive a prescription.

All purchases must be completed, including full payment, and prescriptions issued within 30 days of starting the online vision test process. In order to complete the purchase you must make full payment, provide Todd Smith with a prior prescription or any requested relevant information, and have retaken the vision test if necessary as directed by Todd Smith.

If you fail to complete your purchase within the required 30 days and have paid for your vision test, you will be given an additional 30 days to complete your purchase and receive a prescription by retaking the vision test and providing all necessary information to Todd Smith. You will not be charged for this additional vision test.

All prescriptions must be issued within 30 days of starting the online vision test process. If requested, you must provide Todd Smith with a prior prescription and any requested relevant information within this time frame.

Within 30 days after completing your purchase, you must provide Todd Smith with a prior prescription or any requested relevant information or retake the vision test as directed by Todd Smith.

If you do not provide Todd Smith with the necessary information and/or retake your vision test within 60 days of completing your purchase, your purchase will be deemed abandoned and you will have to re-purchase and retake the vision test at your own expense to receive a prescription.

Todd Smith will not refund any payments for an abandoned purchase.

Todd Smith reserves the right to refund any purchase in its sole discretion.

These cancellation terms are applicable irrespective of the source of the payment for the Services.

Term and Termination

This Agreement shall commence on the date you acknowledge acceptance of this Agreement. Either you or Todd Smith may terminate this Agreement and your right to use Todd Smith at any time, with or without cause. This Agreement and any licenses granted to access the EHR shall terminate without notice in the event you (or any authorized person using your account) fail to comply with the terms and conditions of this Agreement. Todd Smith shall retain your Patient Chart in the EHR for a period of time as required by law.

Limitation of Liability: Indemnification

TO THE FULL EXTENT PERMITTED BY LAW, AND EXCLUDING THE ACCURACY OF THE VISION TEST : (a) IN NO EVENT WILL TODD SMITH BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR PUNITIVE DAMAGES ARISING OUT OF OR RELATED TO THIS AGREEMENT OR THE SERVICES, EVEN IF TODD SMITH HAS BEEN ADVISED OF, KNEW OF, OR SHOULD HAVE KNOWN OF THE POSSIBILITY OF SUCH DAMAGES; AND (b) IN ANY EVENT, TODD SMITH’S TOTAL AGGREGATE LIABILITY IN CONNECTION WITH THIS AGREEMENT, FOR ALL CLAIMS OF ANY KIND (INCLUDING, BUT NOT LIMITED TO, ANY CLAIM RELATED TO THE SERVICES PERFORMED BY TODD SMITH HEREUNDER OR YOUR USE THEREOF), WILL NOT EXCEED THE AMOUNT YOU HAVE PAID TO TODD SMITH DURING THE ANNUAL PERIOD IMMEDIATELY PRECEDING THE FIRST EVENT GIVING RISE TO SUCH LIABILITY.

To the extent permitted by law and excluding the accuracy of the vision test, you agree to release, indemnify and hold Todd Smith and its shareholders (excluding any physicians practicing telemedicine through Optimized Eye Care) harmless for claims or expenses arising from injury or personal damage that occurs in connection with your misuse of the Site, your choice of payment method, or your receipt of notices or information at your contact address.

Disputes

You agree that this Agreement is governed by the laws of the State of Illinois, without regard to choice of law rules. Any dispute arising out of or relating to this Agreement, including the determination of the scope or applicability of this clause, shall be settled by binding arbitration administered in accordance with its Streamlined Arbitration Rules and Procedures. The arbitration shall be heard by a single arbitrator, and shall be conducted in Cook County, Illinois. Each party shall bear his, her, or its own costs relating to such arbitration, and the parties shall equally share the arbitrator’s fees. Judgment on any award resulting from such arbitration may be entered in any court having jurisdiction. If this arbitration provision is deemed invalid, the parties agree that the court of proper and exclusive jurisdiction to resolve any action arising out of this agreement shall be a state or federal court located in Cook County, Illinois.EACH PARTY TO THIS AGREEMENT HEREBY WAIVES ANY RIGHT HE, SHE, OR IT MAY HAVE TO PARTICIPATE IN ANY CLASS ACTIONS OR CLASS ARBITRATIONS.

Notice

Todd Smith will generally communicate with you using the email address or telephone number you provided to Todd Smith. In some circumstances, we may communicate with you using the mailing address you provided to Todd Smith. You may contact Todd Smith on all matters relating to your order or services provided by us by using the following resources:

[email protected]

This Agreement may be amended at any time by Todd Smith upon providing you notice prior to the effective date of the amendment. If you do not agree with the terms of any such amendment, you may terminate the Agreement as provided in the Termination Section.

General Provisions

This Agreement and any related emails or other written documents from Todd Smith that specifically address the Services shall constitute the complete agreement between Todd Smith, Inc., Optimized Eye Care, PC, and you with regard to the Services, and shall supersede all prior and contemporaneous agreements, proposals, representations, warranties, or promises, whether written or oral, relating to the Service. In the event of conflict between this Agreement and any other written document, this Agreement shall control, unless the written document specifically states otherwise.

Todd Smith may subcontract some or all of its obligations under this Agreement, without providing any prior notice to you.

If any provision of this Agreement is, for any reason, deemed unenforceable or in violation of law, such unenforceability or violation will not affect the remaining provisions of this Agreement, which will continue in full force and effect and be binding upon the parties hereto.