Sep 28, 2026 ·
Effective date: 2/1/2007
Sample template. Replace every item in [brackets] with your practice's details. This sample is not legal advice; have a healthcare attorney licensed in your state review it before you publish.
1. Acceptance of These Terms
Welcome to the website of HANSA MEDICAL GROUPE, PLLC ("the Practice," "we," "us," or "our"), located at www.hansamg.com (the "Site"). By accessing or using the Site, including any patient portal, online forms, or scheduling tools linked from it, you agree to these Terms of Service ("Terms").
If you do not agree, please do not use the Site. If you use the Site on behalf of another person, such as a child or a family member you care for, you confirm that you are authorized to do so.
2. Not Medical Advice; Medical Emergencies
If you think you are having a medical emergency, call 911 or go to the nearest emergency room right away. Do not use the Site, the patient portal, email, or online forms to seek emergency care. If you are in crisis or thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline.
Content on the Site, including articles, blog posts, videos, and service descriptions, is for general information only. It is not medical advice, diagnosis, or treatment, and it does not replace an evaluation by a qualified healthcare provider. Always ask your provider about any questions you have about a medical condition. Never ignore professional medical advice or delay seeking it because of something you read on the Site.
3. No Provider–Patient Relationship
Using the Site, sending a message through a general contact form, or submitting an appointment request does not by itself create a provider–patient relationship with the Practice or any of its clinicians. That relationship begins only when a Practice provider agrees to treat you, typically at your first scheduled visit or telehealth appointment.
4. Patient Portal, Appointment Requests, and Online Communications
Patient portal. The portal is operated by third party vendors like CareCloud, could change at anytime and may have its own terms, which also apply when you use it. You are responsible for keeping your login credentials confidential and for all activity under your account. Tell us right away at 847-920-0902 if you suspect unauthorized access.
Appointment requests. An online request is not a confirmed appointment until our staff confirms it with you. Cancellation and no-show policies are described in our Information or Consent Packet also found on our website.
Response times. We aim to respond to portal messages up to within two (2) business days, however we strive to respond sooner. Do not use online messaging for urgent or time sensitive matters; call our office at 847-920-0902 instead. If you live in a senior housing building, please contact a staff member there, in case there is a delay from our team.
Standard email and text. Unencrypted email and text messages are not secure. Please do not send detailed health information through the general contact form or regular email. If you choose to communicate with us that way, you accept the related privacy risks.
5. Privacy and Your Health Information
We protect your protected health information (PHI) as required by the Health Insurance Portability and Accountability Act (HIPAA) and applicable state law. Our Notice of Privacy Practices explains how we use and disclose PHI and your rights regarding it.
Our Website Privacy Policy describes how we collect and use information from Site visitors, including cookies and analytics. We do not use tracking technologies on pages that collect PHI, such as the patient portal or appointment forms, in ways that would disclose that information to third parties without your authorization.
[Confirm this statement against your actual analytics and advertising setup.]
6. Telehealth Services
Telehealth visits are offered through Doxy.me and are subject to a separate telehealth consent you will be asked to sign before your first virtual visit. Our providers can generally treat you by telehealth only if you are physically located in a state where the provider is licensed at the time of the visit. Your provider may decide that an in-person visit is needed. You are responsible for a private location and a working internet or phone connection during the visit.
7. Online Bill Payment
Online payments are processed by Inbox Health, Tebra, or CareCloud, all third-party services. We do not store your full card number on our systems. Payments are applied to your account as of the date we receive them, which may differ from the date you submit them. Questions about your bill should go to our billing office at 847-920-0902 and ask to be transferred to that specific department or leave a message for a communication back.
8. Acceptable Use
You agree not to:
- Provide false information or impersonate another person, including when requesting appointments or accessing records.
- Access or try to access another person's health information without legal authority.
- Interfere with the Site's security, introduce malware, or attempt to gain unauthorized access to our systems.
- Use automated tools to scrape, copy, or collect content or data from the Site.
- Use the Site for any unlawful purpose or to send harassing, threatening, or abusive messages to our staff.
We may suspend or end your access to the Site or the patient portal if you violate these Terms. This does not affect your right to obtain a copy of your medical records under HIPAA.