Terms of Use

Agreement to Terms

By accessing and using the Nivano Physicians website (www.nivanophysicians.com) and related services (collectively, the “Services”), you agree to be bound by these Terms of Use (“Terms”). If you do not agree to these Terms, please do not use our Services.

Effective Date: August 7, 2025
Last Updated: August 7, 2025

Acceptance and Modification of Terms

Your Agreement

Your access to and use of our Services constitutes your agreement to be bound by these Terms and all applicable laws and regulations. These Terms constitute a legally binding agreement between you and Nivano Physicians, Inc.

Modifications

We reserve the right to modify these Terms at any time. Changes will be effective immediately upon posting on our website. Your continued use of the Services after any changes constitutes your acceptance of the new Terms.

Additional Terms

Some Services may be subject to additional terms and conditions, which will be made available to you in connection with such Services.

Definitions

“Services” means our website, patient portal, mobile applications, and any related services
“Content” means all information, data, text, software, music, sound, photographs, graphics, video, messages, tags, or other materials
“User Content” means any Content that you submit, post, or display on or through the Services
“We,” “us,” “our” refers to Nivano Physicians, Inc.
“You,” “your” refers to the individual or entity accessing or using our Services

Eligibility and Registration

Age Requirements

You must be at least 18 years of age to use our Services. If you are under 18, you may use our Services only with the involvement and consent of a parent or legal guardian.

Account Registration

To access certain features of our Services, you may need to register for an account. You agree to:

Provide accurate, current, and complete information during registration
Maintain and update your information to keep it accurate and current
Keep your login credentials confidential and secure
Notify us immediately of any unauthorized use of your account
Accept responsibility for all activities that occur under your account

Account Security

You are responsible for maintaining the confidentiality of your account credentials and for all activities that occur under your account, whether authorized by you or not.

Acceptable Use Policy

Permitted Uses

You may use our Services only for lawful purposes and in accordance with these Terms. Permitted uses include:

Accessing healthcare information and resources
Communicating with healthcare providers through approved channels
Managing your healthcare appointments and records
Educational purposes related to health and wellness

Prohibited Uses

You may not use our Services to:

Illegal or Harmful Activities

Violate any applicable laws or regulations
Infringe on intellectual property rights of others
Transmit harmful code such as viruses, malware, or trojans
Attempt to gain unauthorized access to our systems or other users’ accounts

Misuse of Healthcare Information

Provide false medical information or impersonate others
Use Services for fraudulent purposes or insurance fraud
Share or misuse other patients’ health information
Attempt to obtain controlled substances through deceptive means

Disruptive Behavior

Harass, abuse, or threaten other users or staff
Transmit spam or unsolicited commercial communications
Interfere with the operation of our Services
Use automated systems to access Services without permission

Privacy Violations

Violate the privacy rights of other individuals
Collect personal information about other users without consent
Share login credentials with unauthorized individuals
Attempt to circumvent privacy and security measures

Healthcare-Specific Terms

No Patient-Provider Relationship

Use of our Services does not establish a patient-provider relationship unless you are formally enrolled as a patient and receive direct medical care from our providers.

Medical Information Limitations

Website content is for informational purposes only and is not medical advice
Do not rely on website information for medical decisions
Always consult healthcare providers for medical advice and treatment
Use secure communication channels for confidential medical information

HIPAA Compliance

Our Services are designed to comply with HIPAA regulations:

Protected Health Information (PHI) is safeguarded according to HIPAA requirements
Business Associate Agreements are in place with third-party service providers
Patient portal communications are encrypted and secure
You consent to our privacy practices as described in our Notice of Privacy Practices

Emergency Situations

Do not use our Services for medical emergencies
Call 911 or go to the nearest emergency room for urgent medical needs
Our Services are not monitored 24/7 for emergency requests
Response times may vary for non-emergency communications

Intellectual Property Rights

Our Content

All Content on our Services, including text, graphics, logos, images, audio clips, digital downloads, data compilations, and software, is our property or the property of our licensors and is protected by copyright, trademark, and other intellectual property laws.

Limited License

We grant you a limited, non-exclusive, non-transferable license to:

Access and use our Services for their intended purpose
View and print Content for personal, non-commercial use
Use our Services in accordance with these Terms

Restrictions

You may not:

Copy, modify, or distribute our Content without permission
Use our trademarks or service marks without authorization
Create derivative works based on our Content
Reverse engineer or attempt to extract source code

User Content License

By submitting User Content to our Services, you grant us a non-exclusive, worldwide, royalty-free license to use, copy, modify, distribute, and display such Content in connection with providing our Services.

Privacy and Data Protection

Privacy Policy

Your privacy is important to us. Our collection and use of personal information is governed by our Privacy Policy, which is incorporated into these Terms by reference.

Health Information

PHI is protected according to HIPAA Privacy and Security Rules
Consent to electronic communication may be required for certain Services
Data security measures are implemented to protect your information
Breach notification will be provided as required by law

Cookies and Tracking

We use cookies and similar technologies to improve our Services
You can control cookie settings through your browser
Some features may not function without cookies enabled
Analytics and tracking help us improve user experience

Third-Party Services and Links

External Links

Our Services may contain links to third-party websites or services:

We do not control third-party content or services
Third-party terms and privacy policies may apply
We are not responsible for third-party content or practices
Links do not constitute endorsement by Nivano Physicians

Integrated Services

We may integrate with third-party services for enhanced functionality:

Business Associate Agreements are maintained where required
Data sharing is limited to necessary functions
Third-party service availability may affect our Services
We are not responsible for third-party service interruptions

Communication Terms

Electronic Communications

By using our Services, you consent to receive electronic communications from us, including:

Service-related notifications and updates
Appointment reminders and healthcare communications
Billing and payment information
Policy updates and important notices

Secure Messaging

Patient portal messaging is encrypted and HIPAA-compliant
Email communications may not be secure for confidential information
Response times may vary for different types of communications
Emergency communications should not be sent through electronic messaging

SMS and Text Messaging

If you opt in to receive text messages:

Message and data rates may apply according to your mobile plan
You can opt out at any time by replying “STOP”
We comply with applicable telecommunications regulations
Text messages may contain appointment reminders and health information

Payment and Billing Terms

Financial Responsibility

You are responsible for all charges associated with your use of Services
Insurance verification is your responsibility
Copayments and deductibles must be paid at time of service
Outstanding balances may affect access to Services

Billing Disputes

Review bills promptly and report any discrepancies
Contact our billing department for questions or disputes
Follow appeal processes for insurance-related issues
Maintain current insurance information to avoid billing delays

Service Availability and Modifications

Availability

We strive to maintain continuous availability of our Services
Scheduled maintenance may cause temporary interruptions
Technical issues may affect Service performance
We are not liable for Service interruptions beyond our control

Modifications to Services

We reserve the right to:

Modify or discontinue any aspect of our Services
Update features and functionality as needed
Change Service availability in different geographic areas
Implement new policies affecting Service use

Disclaimers and Limitations of Liability

Disclaimer of Warranties

OUR SERVICES ARE PROVIDED “AS IS” WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT.

Limitation of Liability

TO THE FULLEST EXTENT PERMITTED BY LAW, NIVANO PHYSICIANS SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO LOSS OF PROFITS, DATA, OR USE, ARISING OUT OF OR RELATING TO YOUR USE OF OUR SERVICES.

Maximum Liability

IN NO EVENT SHALL OUR TOTAL LIABILITY EXCEED THE AMOUNT YOU PAID, IF ANY, FOR ACCESSING OUR SERVICES DURING THE TWELVE MONTHS PRECEDING THE CLAIM.

Indemnification

You agree to indemnify, defend, and hold harmless Nivano Physicians, its officers, directors, employees, agents, and affiliates from and against any claims, liabilities, damages, losses, costs, or expenses arising out of or relating to:

Your use of our Services
Your violation of these Terms
Your violation of any rights of another party
Your User Content or activities on our Services

Termination

Termination by You

You may terminate your account and stop using our Services at any time by contacting us or following the account closure procedures in your patient portal.

Termination by Us

We may terminate or suspend your access to our Services immediately, without prior notice, if:

You violate these Terms or our policies
Your account is inactive for an extended period
We cease providing Services in your area
Legal or regulatory requirements necessitate termination

Effects of Termination

Upon termination:

Your right to use Services will cease immediately
Your health records will be retained according to legal requirements
Outstanding obligations will remain in effect
Provisions that should survive will continue to apply

Dispute Resolution and Governing Law

Governing Law

These Terms are governed by the laws of the State of California, without regard to conflict of law principles.

Jurisdiction

Any legal action or proceeding relating to these Terms shall be brought exclusively in the state or federal courts located in Sacramento County, California.

Dispute Resolution Process

Before filing any legal action, you must:

Contact us directly to attempt resolution
Provide written notice of the dispute
Allow 30 days for good faith resolution efforts
Consider alternative dispute resolution methods

Class Action Waiver

You agree that any dispute resolution proceedings will be conducted only on an individual basis and not in a class, consolidated, or representative action.

Miscellaneous Provisions

Entire Agreement

These Terms, together with our Privacy Policy and any additional terms applicable to specific Services, constitute the entire agreement between you and Nivano Physicians.

Severability

If any provision of these Terms is found to be unenforceable, the remaining provisions will remain in full force and effect.

Waiver

Our failure to enforce any provision of these Terms shall not be deemed a waiver of that provision or any other provision.

Assignment

You may not assign these Terms or any rights hereunder without our prior written consent. We may assign these Terms without restriction.

Force Majeure

We shall not be liable for any failure to perform due to circumstances beyond our reasonable control, including natural disasters, government actions, or technical failures.

Contact Information

General Questions

Nivano Physicians
2554 Millcreek Drive, Suite 100, Sacramento, CA 95833
Phone: (916) 407-2000
Email: customerservice@nivanophysicians.com

By using our Services, you acknowledge that you have read, understood, and agree to be bound by these Terms of Use.

Document Version: 1.0
Effective Date: August 7, 2025
Last Updated: August 7, 2025
Next Review: August 7, 2026