Services Agreement

BLOCH Quantum Imaging Solutions, Inc. d/b/a BeSound, through its partnerships with professional services corporations, including, Agape Medical Group, P.C. (“Agape,” or “Provider”), is honored to provide you with access to breast imaging technologies that can enable early detection of cancers in women, especially women with dense breasts whose breast cancers are often missed by other technologies. BeSound solely provides imaging technology to Agape; Agape, through its providers and contractors, is solely responsible for the delivery of radiology and other clinical and licensed professional services. (Collectively, BeSound and Agape are referred to in this document as “us,” “we,” and “our.”)

When you sign this document, it will represent an agreement between you and us. Federal and state law require that we provide to you certain information set forth in this document. A full copy of this Patient Services Agreement will be furnished for your records upon request. If you have any questions, please contact us at people@besoundbreast.com.

1. Our Services

We provide you with a breast ultrasound using our proprietary technology and interpretation, as well as care navigation services related to the results of your ultrasound if needed (collectively, our “Services.”) We partner with a third-party radiology provider to provide medical services, including to read the ultrasound image. At the time of your ultrasound, the Provider will explain the benefits and risks of the ultrasound and you will have the opportunity to ask any questions. You may be asked to sign a separate consent..

2. Accurate Information

You agree to provide accurate and complete information to us in order to receive the Services.

3. Service Charge

The Services cost the amount currently listed on our website. . The portion attributed to the Provider’s or third-party radiology provider’s services is paid to the Provider or third-party, as appropriate.

You agree to pay this fee the day of your Service. If you dispute any charges, you must notify us in writing within sixty (60) days after you are charged. We may, in our sole discretion, offer credits on a case-by-case basis, such as, for example, in the event of an error in the amount you were charged.

4. Credit Card

‍By providing a credit card or other payment method accepted by us (“Payment Method”), you are expressly agreeing that we are (or our service provider is authorized to charge the Payment Method for the total amount due, together with any applicable taxes (collectively, as applicable, a “Purchase”). Credit and other payment card transactions are processed by a third-party payment processor, and you agree to comply with the payment terms of such third-party payment processor. Our current third-party payment processor is Square. You can review their privacy policy at https://squareup.com/us/en/legal/general/privacy-no-account. If you do not have a credit or debit card to pay for such services, please contact us to arrange to pay by cash.

If the Payment Method cannot be verified, is invalid, or is otherwise not acceptable, your Purchase may be suspended or cancelled. You must resolve any payment method problems before we proceed with your Purchase. If a payment is not successfully settled and you do not edit your Payment Method information or cancel your Purchase, you remain responsible for any uncollected amounts and authorize us to continue billing the Payment Method, as it may be updated.

5. No Insurance

Our Providers do not accept health insurance plans, are not in-network with any health insurance plans, and are not enrolled with federal or state healthcare programs, such as Medicare and Medicaid. By choosing to use our Services, you are specifically choosing to pay for our Services out-of-pocket, meaning that  you are solely responsible for the costs of the Services. If you are a federal health program beneficiary, you agree that neither you or we will submit a claim for reimbursement to any federal or state healthcare program for the costs of the services we provide. If you are a Medicare beneficiary, we cannot provide services to you at this time.

6. Scheduling Services

All Services can be scheduled by using the patient portal on the BeSound website at www.besoundbreast.com.

7. Cancellation Policy

You will be charged the full Purchase price for any appointment that is not cancelled or rescheduled at least 24 business hours in advance of the scheduled appointment start time.

8. Telehealth

You may have the option to receive telehealth services from your Provider (“Telehealth Services”). Telehealth involves the use of audio, video, or other electronic communications to interact with you, consult with your Provider, and/or review your information for the purpose of follow-up and/or education. Telehealth may be provided as synchronous (in real time) or asynchronous (not in real time, such as by sending information a photo and later receiving a response). During Telehealth Services with your Provider, details of your medical history and personal health information may be disclosed through the use of interactive video, audio, and/or telecommunications technology. The benefits of telehealth include having access to Providers and education without

having to travel outside of your home or local health care community. The risks are that you can experience interruptions or technical difficulties. Your Provider will explain the security measures in place regarding your Telehealth Services, but in rare circumstances, security protocols could fail, causing a breach of patient privacy. You understand the risks and benefits of receiving Telehealth Services.

You may ask your Provider any questions you may have regarding Telehealth Services, and you understand that you can refuse or discontinue Telehealth Services and are not prevented from receiving in-person health care during a specified course of health care and treatment after agreeing to receive services via telehealth. You agree not to share your appointment link with anyone unauthorized to attend your appointment.

Any licensed provider providing Telehealth Services, such as a radiologist, is also required by California law to provide you with their license or registration number and the type of license or registration each time before they begin Telehealth Services. Your Provider will provide you with a notice explaining that they are licensed/registered and regulated by the Medical Board of California, and their license/registration can be checked and complaints against the licensee/registrant can be made through the Board's website or by contacting the Board. By signing below, you agree that you have read the California notice to consumers regarding provider licensure.

Telehealth Services should not be used for a medical or mental health emergency. In a medical or mental health emergency, or if you are feeling suicidal or that you cannot keep yourself or others safe, you should dial 911, call or chat with the 988 Suicide & Crisis Lifeline, and/or or go to your local hospital’s Emergency Room.

9. Confidentiality and Compliance

We will take appropriate precautions to keep your health information confidential. We may collect or receive certain personal information and other data about you that is governed by federal law, such as HIPAA, on behalf of the Providers who use our technology. Our collection and use of that personal information is subject to the agreement between us and the Providers, if applicable. Your Providers will keep the content of your sessions confidential and in accordance with applicable law. There may be limitations on your privilege of confidentiality, such as if you threaten or attempt to commit grave bodily harm or death upon yourself or another person.

10. Consent to Call, Email, and Text; and App Messaging

You expressly consent to allow us to communicate with you by telephone call, email, text message, messaging via our App, and/or other forms of unencrypted electronic

messaging (“Electronic Messages”) using any telephone numbers or email addresses that you provide us or that we obtain lawfully, such as through caller ID. You expressly agree to receive prerecorded or automated Electronic Messages from us. You agree to receive these Electronic Messages from us even if your phone number is listed on the National Do Not Call Registry. You agree that you are the current owner of any telephone number you provide us. Wireless or data charges from your carrier may apply, and we are not responsible for these charges.

You understand the risks associated with communicating through Electronic Messages, including, without limitation, that Electronic Messages can easily be mis-addressed to or forwarded to unintended recipients, that Electronic Messages can be stored, that backup copies of Electronic Messages may exist even after the Electronic Messages are deleted, that Electronic Messages may not be secure and thus may be used or forwarded without your permission or knowledge, that Electronic Messages may be inspected by your telephone carrier, and that Electronic Messages may be used as evidence in court. You understand that we are not liable for any breaches of confidentiality caused by you or a third party.

You agree that in a medical emergency, you should not use Electronic Messages. Instead, you should call 911.

You understand that Electronic Messages may be filed in your medical record.

You may opt out of automated Electronic Messages, including in-App messages or notifications, SMS, and/or email, at any time. You may send your request to the BeSound team via email to people@besoundbreast.com. You acknowledge and agree to receive a final message confirming your choice to opt out. Unless you revoke your consent to communicate with us via Electronic Messages, your consent will last through the end of your relationship with us.

You acknowledge that telephone calls to or from us may be monitored and recorded. You agree to this monitoring and recording.

In exchange for the services provided by us, you release us from all claims, causes of action, lawsuits, damages, losses, liabilities, or other harms relating to any Electronic Messages you exchange with us. You release BeSound from all claims, causes of action, or lawsuits based on any alleged violations of any laws, including the Telephone Consumer Protection Act, the Truth in Caller ID Act, the CAN-SPAM Act, the Fair Debt Collection Practices Act, the Fair Credit Reporting Act, HIPAA, any similar state and local acts or statutes, and any federal or state tort or consumer protection laws.

11. Liability

‍Liability for the ultrasound reads shall remain solely with the third-party provider performing the professional read; the provider’s name shall be as set forth in the consent and/or ultrasound report.

12. Updates/Revisions

We may update this Patient Services Agreement upon thirty (30) days’ notice to you. Notice and updates will be provided via our App and will be available on our website at people@besoundbreast.com.

13.  Acknowledgments.

By clicking ‘I agree’ to the Services Agreement, you acknowledge that you:

• You have read and understand the information provided above and understand and agree to the terms in this agreement, including the Services, payment methods, and cancellation policy. Any questions you had have been answered.
• You give your informed consent to receive Telehealth Services, as described above in Section 7.