Last Updated: October 15, 2025
This Authorization lets the entities below use and disclose your Protected Health Information (“PHI”) as described here:
• Hoopcare Medical of Florida, P.A., and its partners and vendors — “Practice”
• Hoopcare, Inc., and its partners and vendors — “Hoopcare”
The following PHI may be used or disclosed under this Authorization: all information in my medical files, including but not limited to contact and demographic information; information related to my care or treatment; medical and pharmacy records, including test results; information related to my receipt of health care services.
I specifically authorize the use and disclosure of health information relating to the following types of services I receive (if any):
• Substance use disorder diagnosis, treatment, prognosis, or referral information
• HIV/AIDS-related information, including AIDS-related complex (ARC)
• Genetic testing information
• Mental and behavioral health information (excluding psychotherapy notes)
• Build, operate, and improve Eva Me and related services, products, and technologies.
• Communicate with you about services, features, and offers you can find useful.
• Conduct or sponsor research now or in the future — including recruiting you for research and maintaining research databases or repositories.
• Entities conducting or sponsoring current or future research.
• Health and wellness companies that provide products, services, or technologies that can interest you.
• Hoopcare and Practice partners and vendors that help develop, improve, deliver, or support the services.
• We communicate via the web app, email, and, if you opt in, text message.
• Hoopcare and the Practice can receive compensation for sharing offers or helpful communications, or for disclosures described here.
• Information disclosed under this Authorization can be re-disclosed by a recipient and then no longer protected by HIPAA.
• Signing is voluntary — your treatment, payment, enrollment, or eligibility for benefits does not depend on signing.
• A copy of this Authorization to request at contact@hoopcare.com
• With your consent, records can be requested from Health Information Exchanges and patient portals you connect.
• This Authorization stays in effect while you use Hoopcare services or for fifty (50) years — whichever is later — unless state law requires an earlier expiration.
• You can revoke this Authorization at any time. Send a written request to the address below or contact us at privacy@hoopcare.com. Revocation does not apply to information already used or disclosed in reliance on this Authorization.
• Hoopcare Medical of Florida, P.A. — contact@hoopcare.com
• Hoop Care, Inc. — Privacy — privacy@hoopcare.com
