Terms and Conditions

PERSONAL EMERGENCY RESPONSE SYSTEMS

IN AN EMERGENCY/WHEN HELP IS NEEDED: PRESS THE BUTTON ON THE PENDANT OR THE UNIT. A CARE CENTER REPRESENTATIVE WILL ASK IF YOU NEED HELP.

TESTING

TESTING IS NOT REQUIRED: Unit is completely self-checking, However, we encourage you to use or test the system as often as you desire
TESTING IS REQUIRED: Press the button on the pendant at least once a month, when the person asks if you need help, tell them you are testing

INFORMATION CHANGES

TO UPDATE INFORMATION SUCH AS PHONE NUMBERS, ADDRESSES, AND OR RESPONDER INFORMATION, CALL VRI AT 800-860-4230.

PAYMENTS

PRIVATE PAY CUSTOMERS: YOU ARE RESPONSIBLE FOR ANY FINANCIAL CHARGES AND PAYMENTS TO VRI WHILE UNDER CONTRACT
If you have given your credit card number to VRI, recurring charges will be made on that card. If you have provided bank account info to VRI, funds will automati-cally be drafted from that account. I hereby authorize said deduction
AGENCY/GOVERNMENT CUSTOMERS: PAYMENT FOR APPROVED SERVICES HAS BEEN ARRANGED AND CONTRACTED THROUGH THE AGENCY PROVIDING SERVICE. YOU ARE NOT RESPONSIBLE FOR PAYMENTS ON THOSE APPROVED SERVICES.

QUESTIONS, COMPLIMENTS, COMPLAINTS

IF YOU HAVE QUESTIONS, COMMENTS, COMPLIMENTS, OR COMPLAINTS, PLEASE CALL VRI AT 1-800-860-4230

VALUED RELATIONSHIPS, INC. & SUBSCRIBER AGREEMENT

This agreement is made this _____ day of_________ 20_____, by and between Valued Relationships, Inc. An Ohio corporation and the Subscriber for an Emergency Response System.

 

1. RELEASE OF INFORMATION AND RECEIPT OF UNIT INSTRUCTIONS. You are authorizing Valued Relationships, Inc. to release information about you to other sources involved in providing your care. You are also acknowledging the receipt of the personal emergency response system, training by our representative, written instructions on the use and testing of this unit, as well as how to reach us for any reason.
Subscriber has agreed to placement of the Emergency Response Unit in the
No change to the unit location or changes to telephone wiring my be made by subscriber without prior notice to VRI.

2. SUBSCRIBERS DUTIES:
A. No changes or additions shall be made to the phone network, or any device currently connected to the phone system without a VRI representative being present to test the systems. Phone jacks unused at the time of installation shall remain unused.
B. Subscriber shall not use any caller ID blocking services or devices and acknowledges that VRI requires this information to provide service.
C. Subscriber shall not attach or connect any apparatus or device to the System. Subscriber shall not disturb, remove, relocate, or move the System.
D. Subscriber shall supply 24 hour 110 volt circuits as required to power the System.
E. Subscriber shall provide uninterrupted telephone service or any other equipment that may be deemed necessary to maintain and keep the System operational. Telephone service over the internet or using digital phone lines may be disrupted when no electrical service is present, when internet bandwidth is insufficient, or when power is disabled, preventing the unit from calling VRI.
F. Subscriber shall provide responders access to their home. This document also authorizes other parties in control Of the premises, including prop erty managers, caretakers and maintenance personnel, to grant access to Valued Relationships, Inc. to pick up or perform service on equipment.
G. If Valued Relationships, Inc. is unable to gain access to the home, the subscriber hereby authorizes the police to assist in entry into the home at the expense of the subscriber’s estate. Failure to return the equipment will result in a charge for the equipment or in theft charges being filed

3. PRIVACY NOTICE:
Uses of your health information:
Your health care information shall be provided to organizations involved in your treatment and/or safety. Health care information, including but not limited to, information you provide via the med-connect service on our website, may be provided at our discretion, to individuals responding to assist you in an emergency situation. It is important to keep your health care information updated and current so that VRI can provide accurate information to responders and emergency personnel. Personal and health care information may be provided to our business associates in order to invoice agencies or providers for services rendered on behalf of the agencies members .
Disclosures of Health care information:
In certain situations it may be necessary to disclose health care information under State legal regulations such as Adult Protective Services. VRI will comply with the laws of the State and the member will be notified of said disclosure.
Your Rights:
To access your health care information, contact the Privacy Officer. An access request form may be obtained at 330 Progress Rd. West Carrollton, OH 45449. Access shall mean: the right to see data, the right to request amendments to the data, the right to the accounting of disclosures made by the provider, the right to place restrictions on uses and disclosures and the right for the communications to be confidential. The privacy Officer will respond to your request in writing within (60) sixty days. If your request is denied you may request an independent review of your request. This independent review form may be obtained at 330 Progress Rd. West Carrollton, OH 45449. It is to be submitted to the Privacy Officer, The independent review will take place and be responded to within (60) sixty days.
Privacy Officer:
The designated Privacy Officer for Valued Relationships Inc. is Chris Hendriksen. Telephone: 800-860-4230. Address: 330 Progress Rd. West Carrollton, OH 45449

SUBSCRIBER

VALUED RELATIONSHIPS, INC.

4. TERMS OF THE AGREEMENT: This agreement shall continue for one month and renew automatically unless either party notifies the other in writing 30 days prior to the expiration of this agreement. Payment for services shall be monthly, quarterly or yearly.
5. ASSIGNEES: VRI may transfer or assign the Agreement to any other company at any time. This agreement will remain in force and shall apply to them in the same manner as it applies to us.
6. PREPAID FEES: Upon termination of this agreement, VRI will attempt to refund any prepaid subscriber fees for a period of 90 days from termi-nation, so long as all company owned equipment is returned or recovered. If equipment is damaged or not recovered, V RI is entitled to offset any and all charges against prepaid subscription fees. If after 90 days, V RI has not successfully contacted or located the subscriber or the subscriber’s estate, V RI will earn all prepaid subscription fees and will not be required to refund any payments at any time.
7. VALUED RELATIONSHIPS, INC. IS NOT AN INSURER; LIMITATION OF LIABILITY: You understand that: (a) the amount you pay to us is based only on the value of the service we provide; (b) the system may not always operate properly for various reasons; (c) it is difficult to determine how fast the police or fire department, paramedic unit or others would respond to an alarm signal or dispatch; (d) it is difficult to determine what portion, if any, of personal injury or death would be caused by failure of the system.
8. THEREFORE YOU AGREE:
Even if a court of competent jurisdiction decides that a failure of the system allowed any harm (whether personal injury or death) to you or anyone in your premises or using your system, you agree that our liability shall be limited to $500.00. and this shall be your only remedy regardless of what legal theory is used to determine Valued Relationsh ips, Inc., was liable for the injury or loss.
9. THIRD PARTY INDEMNIFICATION AND SUBROGATION: If anyone other than you, asks us to pay for any harm (including personal injury or death) connected with or resulting from a failure of the system you will reimburse Valued Relationships, Inc. for any amount which a court orders us to pay or which we reasonably agree to pay, including the amount of our reasonable attorney’s fees and any other loss and/or costs that we may pay in connection with harm.
LIMITATIONS OR LAWSUITS; WAIVER OF JURY TRIAL: Both parties agree that no lawsuit or any other legal proceeding connected with
this agreement shall be brought or filed more than one year after the incident giving rise to the claim occurred. In addition any such legal proceeding shall not be heard before a jury. Each party gives up any right to a jury trial.
10. ENTIRE AGREEMENT: The entire and only agreement between you and Valued Relationships Inc., is written in this agreement. It replaces any earlier oral or written understanding or agreements. It may only be changed by a written agreement signed by you and us. If any provision of the agreement if found to be invalid or is illegal by a court, the balance of the agreement shall remain in force. You agree that this agreement shall be governed by the laws of the State of Ohio.
11. OUR LIMITED LIABILITY: We make no express warranty concerning the operation of the system. This agreement limits our liability to $500.00 if you or anyone else suffers any harm (personal injury or death) because the system failed to operate properly, the actions of responders or emergency personnel were improper or inadequate, or we were careless or acted improperly.
12. TELEPHONE LINES: If the Subscriber has more than one telephone extension in the household using the same number, and if one of these phones is in use or off the hook, the System will not operate without installation of an R.J3 1 X jack or line seizures on all phone jacks.
13. ACTS OF GOD: VALUED RELATIONSHIPS, INC. may terminate this Agreement if it can not maintain or secure transmission privileges and shall not be liable for any damages or penalties as a result of such termination. This Agreement may be canceled without previous notice by VALUED RELATIONSHIPS, INC. in the event VALUED RELATIONSHIPS, INC. emergency response centers are destroyed or damaged by any catastrophe and it is impractical to restore service, or it cannot be restored in a timely manner.
14. INTERRUPTION OF SERVICES: VALUED RELATIONSHIPS, INC. assumes no liability for delays in equipment installation, interruption of services due to strikes, riots, floods, fire, acts of God, mechanical or electrical equipment failures, or any cause beyond the control of VALUED RELATIONSHIPS, INC. and will not be required to supply services while said interruption may continue.
15. SUSPENSION OR CANCELLATION: In the event the Subscriber violates any part of this Agreement, abandons or sublets the premises, or causes an excessive number of false alarms, or if the account is more than 30 days past due, VALUED RELATIONSHIPS, INC. may suspend all services and terminate this Agreement upon giving five (5) days written notice to Subscriber. In such event, VALUED RELATIONSHIPS, INC. shall have the right to sever the connection and render the System inoperative and to collect any unpaid debts.
16. MEDICAL OR RELATED EXPENSES: In the event the Subscriber utilizes the System by transmitting a signal to VALUED
RELATIONSHIPS, INC. the Subscriber does hereby authorize VALUED RELATIONSHIPS, INC. to seek to notify or obtain assistance on their behalf. The Subscriber shall be obligated for and agrees to pay any cost and expenses incurred in obtaining assistance, including but not limited to ambulance, police, transportation, physician, nurse, hospital, or other medical assistance, or any cost whatsoever incurred as a result of the
Subscriber’s use of the System.
17. FORCIBLE ENTRY: The Subscriber authorizes VALUED RELATIONSHIPS, INC. in its sole discretion to authorize entry to the Subscriber’s premises in the event a signal is transmitted to the VALUED RELATIONSHIPS, INC. emergency response center. VALUED RELATIONSHIPS, INC. is relieved from any and all liability whatsoever as a result of said entry, including damages to property as a result of forcible entry by emergency personnel.

 

Subscriber Information Form 02-19-15.doc

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