Peak View Behavioral Health Electronic Signature and Records Terms and Conditions

PLEASE READ THE FOLLOWING IMPORTANT INFORMATION ABOUT RECEIVING REQUIRED DISCLOSURES AND OTHER COMMUNICATIONS REGARDING YOUR PATIENT ACCOUNT FROM PEAK VIEW BEHAVIORAL HEALTH IN ELECTRONIC FORMAT.

From time to time, Peak View Behavioral Health may be required by law to provide you with certain written information (collectively, “Required Disclosures”). You are consenting to Peak View Behavioral Health’s provision of such Required Disclosures to you electronically through the Peak View Behavioral Health Patient Portal, in lieu of receiving paper hardcopies.

If you consent to receiving Required Disclosures from us electronically, your consent applies to any future Required Disclosures regarding your patient account. We also may, at our option, mail any Required Disclosures in paper form to your mailing address on file if we choose to do so.

Getting Paper Copies

At any time, you may request a paper copy of any record provided or made available electronically to you by us. You may contact us to request a copy at (719) 444-8484. Paper copies will be provided to you although there may be a nominal fee involved. Please ask when requesting paper copies.

Withdrawing Your Consent

If you prefer to receive only paper hardcopies of any Required Disclosures, you may withdraw your consent on the Peak View Behavioral Health Patient Portal or by contacting us at (719) 444-8484. If you elect to receive the Required Disclosures in paper format only, it will slow the speed at which we can deliver services to you, as we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive acknowledgment of your receipt of such paper notices or disclosures.

Hardware and Software Requirements

To access and retain Required Disclosures electronically, you will need the following: Internet access, a valid e-mail address, and a printer or sufficient computer disk space to download a copy of any Required Disclosures we may provide to you. In addition, you must have a computer or a mobile device that supports one of the following:

• The latest version Internet browser, such as:
  • Microsoft Edge
  • Chrome
  • Firefox
  • Safari

Updating Your Contact Information

Please keep us informed of any changes to your contact information, including your email address. You may update your contact information on the Peak View Behavioral Health or by contacting us at (719) 444-8484.