Mommi Consent


 

 

CONSENT FOR PARTICIPATION IN MOMMIHEALTH PROGRAM

This consent form outlines the terms of use for your participation in the MommiHealth Program (the “Mommi Program”). The Program uses text messages and virtual sessions to provide peer support through trained Mommi Coaches, as well as medical advice from licensed medical professionals (“Professionals”).

By signing up for the Mommi Program, you acknowledge and agree to the following:

  • Mommi Coaches who are not also Professionals do not provide medical advice. These Mommi Coaches provide lay peer support and advice based upon experience as a mom.
  • A Mommi Coach who is not a Professional can connect you with a Mommi Professional if you have a medical question or need to speak with a Professional.
  • Mommi does not contact or follow up with your personal providers, such as your OB-GYN or your primary care physician. Mommi also does not transfer any medical information you share with Mommi Professionals to these providers. If a Mommi Professional recommends that you see your personal provider, it is your responsibility to contact your personal provider and get care.
  • The Program does not establish a professional-patient relationship between you and any Mommi Professional.
  • Mommi is not a substitute for your regular primary care physician, OB-GYN, or any other clinical professional. It is extremely important to attend all medically necessary appointments with your personal providers.
  • Mommi Professionals cannot prescribe anything to you, but can provide you information about a recommended drug to bring to your personal provider for discussion.
  • Mommi Professionals are providing clinical advice without the benefit of seeing you or being able to perform a physical exam. Therefore, you are responsible for being as accurate as possible when describing your medical condition and questions to Mommi Professionals. You further understand that Mommi makes no guarantees as to the outcome of your use of the Program.
  • Mommi does not accept insurance and will not submit any claims or information to your insurance company.
  • By signing this consent, you agree that you are subject to, and will comply with, our privacy policy and terms of service.
  • By signing up for the Program, you agree to receive both autodialed and manually dialed text messages from Mommi, as well as educational content. Mommi Coaches and Professionals are available to you between 6am and 10pm eastern standard time by texting 864-336-2731. Save this number as “Mommi” on your phone. You understand that by agreeing to receive text messages through your phone’s standard texting app, those messages are not secure and may be intercepted by a third party. Mommi makes no guarantee as to the security or confidentiality of such messages.
  • Virtual sessions shall be conducted through Doxy.me, a HIPAA-compliant platform. When engaged in a virtual session, it is not advisable to do so in public where others may hear your session or where use of public WiFi may put the session at risk.
  • If you experience issues with your phone service, you may be unable to contact Mommi and your communications may be delayed. You are responsible for ensuring your phone service can support the Program.
  • If you wish to stop using the Program text STOP to the Mommi number.

You may opt-out of receiving text messages from the Program by replying STOP to the last text message you received from us. If you opt-out of receiving text messages, you are automatically terminated from the Program.

Mommi will never use your number or information to send you marketing materials or sell your number to any third party. Mommi may share your number or information with its third party vendors in order to facilitate the provision of the Program.

Mommi is for non-urgent and non-emergent medical questions only. If you experience a medical emergency, immediately go to the nearest emergency room or dial 9-1-1. Mommi is not an emergency or urgent care service provider and cannot guarantee an answer your medical questions in an emergent or urgent manner.

Mommi and the Mommi Program are independently owned, controlled, managed and operated, and are not related and/or affiliated in any manner whatsoever with any medical practice or hospital.  I acknowledge that my participation in the Mommi Program is completely voluntary and separate and apart from the care I, or my child receives at any medical practice or hospital; furthermore, I understand that the care that I receive at my or my child’s medical practice or hospital will not be affected by my decision to participate or not participate in the Mommi Program.

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Signature Certificate
Document name: Mommi Consent
lock iconUnique Document ID: fc71fc78c733f06599b6ed06aa208baf1e1f9a31
Timestamp Audit
July 11, 2022 11:00 pm ESTMommi Consent Uploaded by Jessica Gaulton - jessica@mommi.us IP 144.202.16.149, 34.102.219.146