Privacy, Communication & Records Coordination Authorization
Version 1.0 | Effective Date: August 21, 2026.
This authorization explains how America Med Connect LLC (“AMC”) may communicate with the Client and with healthcare providers and other authorized persons while coordinating a medical-travel case. AMC is a non-clinical medical travel and care-coordination company and does not intend to serve as the Client’s medical-record custodian.
1. Purpose
The Client authorizes AMC to communicate and coordinate with healthcare providers, facilities, interpreters, travel partners, and other authorized persons for purposes related to provider consultations, scheduling, records-transfer instructions, provider requests, treatment-plan logistics, travel timing, recovery logistics, and other non-clinical coordination.
2. AMC’s Role in Medical Records
The Client is responsible for obtaining or requesting medical records required for provider evaluation. AMC may identify records requested by a provider, explain where or how to send them, provide provider-supplied transfer information, help coordinate communication, and confirm receipt when practical. AMC’s standard process is to guide and facilitate the medical-records transfer process rather than routinely obtaining, collecting, or permanently storing medical records.
Whenever practical, medical records should move directly from the Client or existing healthcare provider to the receiving healthcare provider.
3. Provider Release Requirements
A physician, hospital, clinic, laboratory, imaging facility, pharmacy, or other healthcare provider may require its own medical-record release or HIPAA authorization. This AMC authorization does not replace provider-required releases.
4. Information AMC May Receive
Although AMC intends to minimize possession of medical records, health-related information may sometimes be provided during ordinary coordination, including procedure or specialty of interest, provider and facility information, appointment and treatment dates, provider-requested testing, travel or mobility restrictions communicated by a provider, recovery timing, treatment-plan documents, and information voluntarily sent to AMC.
5. Authorization to Communicate With Providers
The Client authorizes AMC to communicate with healthcare professionals and facilities participating in the evaluation or coordination of the case regarding scheduling, required documents, provider availability, treatment-plan status, estimates, travel timing, follow-up scheduling, and provider instructions that need to be communicated. AMC will not independently interpret medical records or provide medical advice.
6. Information AMC May Share
When necessary for coordination and authorized by the Client, AMC may share information with an appropriate healthcare provider or other authorized recipient. AMC should limit information shared to what is reasonably relevant to the coordination purpose and should not alter clinical information in a way that changes its meaning.
7. Preferred Records-Transfer Method
Whenever reasonably practical, records should transfer directly between the Client and receiving provider or between the Client’s existing healthcare provider and the receiving provider. If AMC temporarily receives a document because direct transmission is impractical, AMC may transmit it to the intended authorized recipient using an approved method and should not retain it longer than reasonably necessary, subject to legal, contractual, dispute-resolution, or retention requirements.
8. Communication Methods
AMC may communicate through methods approved by the Client, including email, telephone, SMS/text, WhatsApp, videoconference, client portal, secure electronic file transfer, or other approved channels. Different communication methods have different privacy and security risks.
9. Sensitive Information in Email and Messaging
AMC will attempt to avoid unnecessary medical detail in email subject lines, calendar titles, general messaging threads, travel itineraries, and operational trackers. When sensitive documents must be transferred, AMC may instruct the Client to use a more appropriate transfer method.
10. Authorized Family Member or Companion
The Client may separately authorize AMC to communicate with a family member, companion, or representative about specified coordination matters. AMC may verify that person’s identity before discussing sensitive information.
11. Interpreters and Translation
If interpretation or translation assistance is requested, the Client authorizes AMC to coordinate with an interpreter or translation provider as reasonably necessary. Only information reasonably necessary to perform the authorized service should be disclosed.
12. Travel and Other Non-Medical Vendors
AMC will not ordinarily disclose detailed medical records to hotels, drivers, airlines, tour providers, or other non-medical vendors. AMC may disclose limited information reasonably necessary to provide an authorized logistical service, such as mobility needs, pickup location, appointment timing, accessible-lodging needs, or companion arrangements.
13. Minimum-Necessary Principle
AMC intends to use and disclose only the amount of sensitive information reasonably necessary for the coordination task involved and to limit access to personnel and authorized parties who reasonably need the information.
14. No Sale of Medical Information
AMC will not sell the Client’s medical records or personal health information as a commercial data product and will not authorize unrelated advertising use of medical information without separate legally sufficient permission where required.
15. Marketing and Testimonials
This authorization does not authorize AMC to use the Client’s name, image, medical story, treatment details, testimonial, before-and-after photographs, or other identifying information for advertising, social media, website content, or promotional purposes. Separate authorization is required where appropriate.
16. Emergency Situations
This form does not authorize AMC to provide emergency medical care. During an emergency or serious clinical concern, AMC may assist with non-clinical communication and coordination, including helping contact the treating provider, facility, local emergency services, authorized companion, transportation, or interpreter.
17. Privacy Incidents
If AMC becomes aware that sensitive information may have been sent to the wrong recipient, lost, accessed improperly, or otherwise compromised, AMC will follow applicable privacy and incident-response procedures and any legally required notification requirements.
18. HIPAA and Other Privacy Laws
Different privacy laws may apply to different organizations participating in the Client’s care. A U.S. healthcare provider may be subject to HIPAA, while a provider outside the United States may be subject to the laws of its country. AMC will use reasonable health-information privacy practices but does not represent through this form that AMC is a HIPAA-covered healthcare provider.
19. Voluntary Authorization
The Client may ask questions before signing. Refusing to authorize necessary coordination may limit AMC’s ability to communicate with providers or perform services requiring such communication.
20. Revocation
The Client may revoke this authorization in writing by emailing amc@americamedconnect.com. Revocation applies to future AMC coordination after AMC receives and reasonably processes the revocation and cannot undo communications or disclosures already made, provider actions already taken, records already transmitted, transactions already authorized, or information AMC is legally or contractually required to retain.
21. Expiration
Unless revoked earlier, this authorization is intended to expire twelve months after the AMC case is closed unless another date is specified in writing.
22. Client Rights
The Client may request a copy of the signed authorization, information about how AMC coordinates the case, correction of inaccurate non-clinical information where appropriate, removal of an authorized representative from future communications, or a change to communication preferences.
23. Client Acknowledgment
By signing or electronically accepting this authorization, the Client acknowledges that they understand AMC’s non-clinical role, understand AMC does not intend to be the permanent custodian of medical records, understand separate provider release forms may be required, authorize AMC to communicate with providers as reasonably necessary for coordination, and understand that this authorization may be revoked as described above.
Document Status: Current operating version.