BY SUBMITTING THIS FORM YOU AGREE TO THE FOLLOWING:
This system gives you access to your patients’ diagnostic images and interpretation via the Internet. The first step in accessing this system is to obtain your unique username and password. To obtain your username and password you must complete and accept this form. After submission, you will receive an enrollment email to process your request within 24-48 business hours. Please provide a business phone number than can be verified. Do not provide a mobile number or a phone number that cannot be verified.
As healthcare providers, you should be well aware of the safeguards required by the Health Insurance Portability and Accountability Act (HIPAA) to protect patient protected health information (PHI). River Ranch Radiology/Sendero Imaging is dedicated to maintaining strict compliance and adhering to all privacy standards set forth by HIPAA rules and regulations.
SECURITY AGREEMENTIn using River Ranch Radiology/Sendero Imaging’s PACS system, you hereby agree to use protected health information (PHI) for the sole purpose of treating and diagnosing your patient(s) only and for no other purpose except those allowed by federal and state laws. This site is intended for physician and/or healthcare provider use only.
By submitting this form you also agree to:
- 1. Notify the privacy officer of River Ranch Radiology and Sendero Imaging of any use or disclosure of PHI not permitted by this agreement or by federal and state laws. email@example.com
- 2. Access PHI in which you are only authorized to access by federal and state laws.
- 3. Implement appropriate safeguards to prevent the use or disclosure of PHI not permitted by this agreement or by federal and state laws.
- 4. Ensure compliance of authorized users who have access to https://zfp.rspacs.com or https://www.rspacs.com .
- 5. Allow access to https://zfp.rspacs.com or https://www.rspacs.com for authorized users who must access PHI for routine job performance.
- 1. Each authorized user must request a unique username and password.
- 6. Use appropriate safeguards to protect your username and password from unauthorized access.
- 1. Control the dissemination and use of your username and password.
- 2. Monitor the use of your username and password.
- 3. Inform if there is any need to deactivate your username and password.
- 7. Notify firstname.lastname@example.org or email@example.com when any of your authorized users have terminated employment with your practice so we may deactivate their username and password.
River Ranch Radiology/Sendero Imaging reserves the right to monitor the usage of this system to ensure this service remains available to authorized users. To ensure the data transmitted between you and River Ranch Radiology/Sendero Imaging is not viewed by unauthorized users, we use Secure Socket Layer (SSL) encryption for this website. Any attempt to modify this program or associated information is strictly prohibited and may be punishable under the Computer Fraud and Abuse Act of 1986.
River Ranch Radiology/Sendero Imaging reserves the right to terminate this agreement and use of https://zfp.rspacs.com or https://www.rspacs.com upon making the determination that there has been a violation or breach of the terms and conditions of this agreement. This allows us to reserve the right to monitor the usage which includes but not limited to audit logs / trails. Any individuals found to have divulged or allowed unauthorized disclosure of patients protected health information may be reported to DHHS and their access will be terminated. Any criminal violations committed knowingly can result in penalties of $50,000 plus a year in prison. Violations for obtaining or disclosing PHI under false pretenses can result in penalties of $100,000 and up to five years in prison. Finally, obtaining PHI with the intent to sell, transfer or use it for commercial gain, personal gain or malicious harm can yield fines of up to $250,000 and 10 years in prison.
River Ranch Radiology/Sendero Imaging does not collect any personal information other than what is collected during the username request to verify your identity as a physician and/or helathcare provider. We may revise or update this statement to remain in compliance with security and privacy laws. Your continued use of these sites constitutes your agreement/acceptance to these revisions. If you do not agree to these conditions set forth in these statements, please discontinue use of this site immediately and notify the privacy officer at firstname.lastname@example.org .