1. Terms Defined

   a. "Affiliates" denote the collective group of an organization's leaders, staff, officers, directors, agents, legal advisors, representatives, partners, joint ventures, parent companies, subsidiaries, successors, and assigns. An "Affiliate" pertains to any single member of this group.

 

   b. "Claims" encompass all claims, disputes, disagreements, issues, and causes for legal action. A "Claim" refers to any individual component of this group.

 

   c. “Replenish Content" represents all forms of data, information, content, and intellectual property accessible through our Services, provided in various formats such as code, text, images, multimedia elements, designs, graphics, illustrations, photos, banners, messages, videos, visual interfaces, features, functions, and software applications, but specifically excluding Personal Information and User Content.

 

   d. "Replenish," the "Company," "us," "our," and "we,"** all designate Replenish IV Solutions, INC,  designated S corporation duly incorporated and existing under the laws of the State of Georgia.

 

   e. "Losses" include collective liabilities, damages, losses, debts, financial penalties, awards, fees, costs, and fines. A "Loss" refers to any individual component of this list.

 

   f. "Lab Results" refer to the outcomes of any and all analyses conducted on samples. However, they do not include the formatting, graphical representation, or any other Replenish Content associated or provided along with your Lab Results obtained from third-party laboratories.

 

   g. "Party" signifies each entity in the relationship, you or Replenish. Together, you and Replenish Health are known as the "Parties."

 

   h. "Payment Information" refers to financially sensitive details that enable transactions, such as credit/debit card numbers, security codes, expiration dates, and personal identification numbers.

 

   i. "Payment Method," refers to a valid, current, and accepted way to make payments for Services as per Function's guidelines—generally by using a valid, current, accepted means.

 

 j. Updated Payment Details 

Refers to the current, approved method(s) of payment.  

 

k. "Personal Information"  

This mirrors the definition outlined in our Privacy Policy, incorporating details about an individual's health background, such as their medical history, relevant data, blood type, and current health conditions or symptoms. It covers Sample data and/or Lab Results, provided they are not categorized as "protected health information" or "medical information" under the Health Insurance Portability and Accountability Act of 1996 or any applicable laws, as detailed in our Privacy Policy. Additionally, "Personal Information" might encompass certain Payment Information.  

 

 

l. “Samples”

These are blood samples submitted by Replenish customers to independent third-party labs for reporting purposes associated with Replenish’s Services.  

 

m. “Services”

All services related to or provided by Replenish. This encompasses:  

 

1.. “Access Facilitation”  

   - Easy access to third-party laboratory services for Sample collection.  

 

2. “Lab Result Access” 

   - Secure access to Lab Results linked to those Samples, along with a comprehensive, user-friendly report.  

 

3. “Professional Connection” 

   - Options to engage with third-party medical experts pertaining to test orders and resulting Lab Results.  

 

4. “Informational Provision” 

   - Health and wellness advice, including insights on fitness, diet, and lifestyle, tied to Lab Result parameters.  

 

NEITHER REPLENISH NOR OUR ASSOCIATED COMPANIES OFFER MEDICAL ADVICE, TREATMENT, OR DIAGNOSES THROUGH OUR SERVICES, AND ENGAGING WITH OUR SERVICES DOES NOT FORM A DOCTOR-PATIENT RELATIONSHIP BETWEEN YOU AND FUNCTION OR ITS AFFILIATES.

 

n. "User Content" is defined as any and all content—including text, photos, graphics, images, videos, audio files, multimedia, and other materials—that you create, alter, post, submit, upload, transmit, and/or share while using our Services. User Content explicitly excludes user passwords, contact details, Personal Information, or any "protected health information" or "medical information" protected by the Health Insurance Portability and Accountability Act of 1996 or other relevant laws, as described in our Privacy Policy. This term applies to any content that is publicly viewable or shared through photos, graphics, images, or any other materials.  

 

o. "You," "you," "your," "yourself," and "User”, “Customer”, pertain to you as an individual and extend to any organization, entity, or person on whose behalf you are utilizing our Services

 

Replenish— Georgia Disclosures, Consent, and Terms 

 

By my signature, I acknowledge and agree to the following terms of Service:

1) Overview

- Replenish (“we,” “us,” “our”) provides elective services that include: (a) ordering lab tests; (b) sending preparation instructions; and (c) delivering lab results with a written summary via a secure third‑party portal. 

- We are not your primary healthcare provider and do not replace the care, diagnosis, or treatment of your clinician.

 

2). Scope of services

Replenish helps Georgia residents order certain laboratory tests through independent, CLIA‑certified labs and view results in an online dashboard.

- We provide plain‑English result summaries and general nutrition and wellness education.

- We do not diagnose, treat, prescribe, or manage medical conditions. We are not a clinical laboratory and do not collect specimens ourselves.

 

3) Not medical advice; no provider–patient relationship; Emotional Impact

 -Our services and summaries are informational and not medical advice, diagnosis, or treatment.

-Not a substitute for clinical care

- Our Services are not a replacement for care from a licensed healthcare professional who knows your medical history. Always consult your own qualified clinician before making decisions about diagnosis, treatment, or care, including decisions informed by any data or information obtained through our Services. You agree not to delay seeking care or disregard professional guidance because of information from our Services.

- Information on our site, app, emails, and summaries is for educational purposes only and is not medical advice.

- Using Replenish does not create a provider–patient relationship with Replenish or with any clinician who may authorize a test order.

- Lab results may be unexpected, life‑altering, and upsetting, and may cause anxiety. You agree to have a licensed clinician to support you, especially for concerning or negative results.

- Our services are not for emergencies. If you are in crisis or believe you have a medical emergency, call 911 or your local emergency number.

- Always consult your own clinician for diagnosis, treatment, or questions about your results.

 

5) Your choice of providers and your responsibility to maintain one

- You acknowledge that you choose any healthcare provider or laboratory from whom you seek services and that you elect to receive testing or other services at your own discretion. You are responsible for maintaining an ongoing relationship with a licensed clinician for your medical needs and for sharing any test results or information obtained through our Services with that clinician.

 

4) Eligibility and geography

Client Warranties. I expressly represent and warrant to Replenish that:
(a) I am at least 18 years of age, and
(b) I know my pregnancy status and have informed Replenish, and have answered Replenish’s medical intake form to the best of my knowledge. I understand that filling out the information honestly can help allow for an accurate summary

You must be 18 or older and be physically located in Georgia when your specimen is collected.

- Our services are currently offered only for use in Georgia. You may not use them for emergencies.

- You must have your own licensed healthcare provider and you agree to consult them after your results are released.

 

5) Test ordering model (Georgia)

- Under Georgia law, many clinical laboratory tests require an order from a licensed clinician. Replenish works with independent, Georgia‑licensed clinicians solely to review requests and, if appropriate, authorize test orders.

- That clinician’s role is limited to ordering and, where required, reviewing critical or reportable results. They do not provide ongoing care through Replenish.

- All testing is performed by independent, CLIA‑certified laboratories. Laboratory names and addresses are provided to you on your order form and laboratory instructions sent via our secure portal. 

 

6) Third‑Party Services and Labs

- We use independent third parties (including labs, couriers, and a secure results portal). We choose which lab(s) to use. You have the right not to use our service if you do not wish to use those labs.

- We are not responsible or liable for third‑party acts or omissions, including data handling or storage, sample handling, delays, user error, incomplete draws, lost samples, shipping issues, or need for repeat testing.

- If you use an at‑home kit, you are responsible for following all instructions. User error can require repeat testing at your cost.

 

7) Informed consent for testing

By proceeding, you acknowledge:

- Purpose and benefits: Lab testing may help you learn about general health and wellness markers.

- Risks and limitations: Tests can have false positives/negatives; results may be affected by timing, medications, supplements, hydration, or collection errors. Abnormal results may require confirmatory testing and extra costs with your clinician.

-for potential risks associated with blood draws, such as pain, infection, bruising, or other related complications. These risks are inherent to the procedure.

You acknowledge the nature of the Services and understand that they carry certain risks.
 

- Alternatives: You may obtain testing through your own clinician or another lab service.

- Insurance and records: We do not bill insurance. We do not share your test results with insurance. Using direct‑to‑consumer testing, if you decide to disclose with your insurance company, may affect future insurance eligibility or rates in limited scenarios (e.g., life/disability insurance). Ask your insurer for details.

- Follow‑up: You are responsible for consulting your clinician about any results.

 

8) Preparation and Your Responsibilities

- We will send preparation instructions before each lab. You are responsible for following them to help ensure accurate results. If you do not prepare as directed, we are not responsible for inaccurate or unusable results or repeat testing, including cost of repeat testing.  

- You must provide accurate, current information, including your legal name, date of birth, contact information, and any other requested details.

 

9) Result interpretation limits

- Reference ranges may vary by lab, age, sex, and method. Out‑of‑range results are not a diagnosis.

- Our summaries, flags, and education are informational and may not reflect your specific medical situation.

- Only your clinician can provide diagnosis, medical advice, or treatment.

 

10) Critical Values and Communications

- If a lab reports a critical value, our medical team will make reasonable efforts to call you at the phone number you provided. If we cannot reach you, we will also email you.

- You are solely responsible for providing a correct, working phone number and email and for monitoring them. We are not responsible if we cannot contact you due to incorrect or missing information, blocked calls, full voicemail, spam filters, service outages, or other issues beyond our control.

- You consent to receive communications related to your order and results by phone, voicemail, text, and email.

 

11) Emergencies and urgent symptoms

- Do not use Replenish for emergencies. If you have chest pain, trouble breathing, severe bleeding, thoughts of self‑harm, or other urgent symptoms, call 911 or seek immediate care at the nearest emergency department.

- If we cannot reach you, we may leave a general message asking you to call us, check your email, and log in to the laboratory app. Ensure your contact information is accurate.

 

12) Public health reporting (Georgia)

- Certain results (for example, some infectious diseases) must be reported by laboratories and/or clinicians to the Georgia Department of Public Health, as required by law. We and our partners will comply with all reporting obligations.

 

13) Results and Summaries

- Turnaround times are estimates and are not guaranteed.

- Results and written summaries are provided through a secure third‑party portal. We do not control the availability or performance of that portal.

- You agree to discuss all results with your own healthcare provider. We may, at our discretion, offer general guidance but do not provide ongoing medical management through this service.

 

14) Repeat Testing; Quality Controls

- Labs may require repeat testing for quality control or unusually high/discordant results. We may recommend or require a repeat test at our discretion.

- Unless caused solely by our error, you are responsible for any costs of repeat testing, additional kits, or additional collections.

 

15) Nutrition and wellness content disclaimer

- Any nutrition and wellness information we provide is general education, not individualized medical nutrition therapy.

- If you book individualized nutrition care, it will be delivered only by a Georgia‑licensed dietitian nutritionist under a separate agreement and consent. Otherwise, no dietetics, medicine, or nursing services are being provided.

 

16) User responsibilities

- Provide accurate, current information and follow all collection instructions.

- Review your results and follow up with your own clinician for interpretation, diagnosis, treatment, or confirmatory testing.

- Do not use our services for emergencies, urgent symptoms, or to start/stop medications without clinician guidance.

 

17) Privacy and data use (HIPAA and Georgia)

- 4. Privacy. Replenish is dedicated to maintaining the privacy of your individually identifiable health information
(also called protected health information, or PHI). In providing the Services, Replenish will create records regarding you and the treatment and Services provided to you. Replenish is required by law to maintain the confidentiality of the health information that identifies you and to provide a notice of its legal duties and privacy practices that it maintains concerning your PHI. By signing below, I acknowledge receipt of Replenish's Privacy Policy and I authorize Replenish to use and/or disclose certain PHI about me, if needed,
in accordance with its Privacy Policy. This authorization permits Replenish Health  to use and/or disclose the following PHI: Date(s) of Services, type of Services, origin of information, age, gender, lab results to provide, coordinate, or send results, recommendations, or reminders for recommended repeat tests and for any other use required by law. I understand that I can revoke this authorization at any time, except to the extent that Replenish Health has acted in reliance upon this authorization. This authorization will expire one (1) year from the original date of Service and will automatically renew for a period of one (1) year for every repeat Replenish Services you choose to use.

5. Email Notifications. I agree that Replenish may send me email notifications including re-testing reminders, referrals, and general news about Replenish. I may unsubscribe from newsletters at any time.
-Labs and ordering clinicians are HIPAA covered entities. Replenish may act as their business associate when handling protected health information on their behalf; in that context we follow HIPAA.

- When we collect data directly from you for our own purposes (e.g., account management, product improvement, marketing with your consent), HIPAA may not apply; our Privacy Notice explains how we collect, use, share, and protect data.

- Data we collect may include account details, contact info, demographics, health‑related information you provide, orders, results, and communications. We use it to provide services, coordinate with labs/clinicians, comply with law, improve the product, and, with consent, send offers.

- We share data with service providers (IT, support), labs, ordering clinicians, and as required by law (e.g., public health). We do not sell personal information.

- Security: We use administrative, technical, and physical safeguards appropriate to the data. No system is 100% secure.

- Retention: We retain information as needed for service, legal, and audit purposes, then delete or de-identify it per our policies.

- Breach notice: In the event of a data breach, we will notify you and regulators as required by applicable law, including Georgia’s breach notification statute.

 

18) Telehealth consent (if any clinical interaction occurs)

- Any interaction with an ordering clinician may occur via telehealth. Telehealth has benefits (convenience) and risks (privacy, technology failures).

- You consent to receive communications electronically and understand you can withdraw consent by not using the service.

- You may be referred to your own clinician or to in‑person care when appropriate.

 

19) Payment, Refunds, and Cancellations

- Fees are due at the time of order. Because ordering triggers costs with third parties, fees are non‑refundable once an order is placed.

-If a specimen is rejected, we will work with you and the lab on a re‑collection

- We may, at our discretion, cancel or refuse an order (for example, for safety, eligibility, or operational reasons) and will address refunds consistent with our then‑current policy.

- Prices and available tests may change without notice.

 

20) Privacy and Data

- We take reasonable administrative, technical, and physical measures to protect information we control. However, no system is 100% secure.

- We are not responsible for third‑party systems’ security, availability, or data practices, including any secure portal or lab. Your use of third‑party services is subject to their terms and privacy policies.

- See our Privacy Policy for details on how we handle your information.

 

21) No Warranties

- Services are provided “as is” and “as available.” We disclaim all warranties, express or implied, including merchantability, fitness for a particular purpose, accuracy, and non‑infringement.

- We do not warrant uninterrupted or error‑free operation, or that results will meet your expectations or be suitable for any particular clinical decision.

 

22) Limitation of Liability

- To the maximum extent permitted by law, we are not liable for any indirect, incidental, special, consequential, exemplary, or punitive damages, or for loss of profits, data, goodwill, or emotional distress, arising out of or related to the services.

- Our total liability for any claim will not exceed the amount you paid to us for the specific service giving rise to the claim.

- These limits apply even if we have been advised of the possibility of such damages and apply to the fullest extent permitted by law.

 

23) Indemnification

- You agree to indemnify, defend, and hold harmless Replenish and its officers, directors, employees, contractors, and agents from any claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys’ fees) arising from your use of the services, your breach of these Terms, your provision of incorrect information, or your interactions with third parties.

 

24) Your consent and acknowledgments

By using Replenish in Georgia, you confirm that:

- You are 18+ and located in Georgia for specimen collection.

- You have read and understand these disclosures and consent to testing.

- You understand Replenish does not provide medical care and that you will consult your clinician for diagnosis and treatment.

- Our total liability for any claim will not exceed the amount you paid to us for the specific service giving rise to the claim.

- These limits apply even if we have been advised of the possibility of such damages and apply to the fullest extent permitted by law.

 

25) Indemnification

- You agree to indemnify, defend, and hold harmless Replenish and its officers, directors, employees, contractors, and agents from any claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys’ fees) arising from your use of the services, your breach of these Terms, your provision of incorrect information, or your interactions with third parties.

 

26) Changes to Services and Terms

- We may modify or discontinue services or update these Terms at any time. Changes are effective when posted. Continued use after changes means you accept the updated Terms.

 

27) Governing Law and Disputes

- These Terms are governed by the laws of Georgia, without regard to conflict‑of‑law rules.

- Any dispute will be resolved in the state or federal courts located in Fulton County, Georgia, and you consent to their jurisdiction and venue. If we mutually agree to arbitration in writing, arbitration rules will apply.

 

28) Entire Agreement; Severability; Assignment

- These Terms, plus any referenced policies, are the entire agreement between you and us regarding the services. If any part is unenforceable, the rest remains in effect. We may assign these Terms; you may not assign without our consent.

 

Contact

- Replenish 

-525 North Ave NE Suite 300 Atlanta GA 30308

-hello@replenish_health.org

 

 

HIPPA NOTICE OF PRIVACY PRACTICES

REPLENISH, SCORP 

HIPAA NOTICE OF PRIVACY PRACTICES

As required by the Privacy Regulations Promulgated Pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out its services and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. 

Uses and Disclosures of Protected Health Information: Your protected health information may be used and disclosed by Replenish, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing services to you, to support the operation of the organization, and any other use required by law. 

 

Payment: Your protected health information may be used, as needed, to obtain payment for services. 

Healthcare Operations: We may use or disclose, as‐needed, your protected health information in order to support the business activities of Replenish. These activities include, but are not limited to, quality assessment activities, employee review activities, and conducting or arranging for other business activities. 

We may use or disclose your protected health information in the following situations without your authorization: as Required By Law, Legal Proceedings, Law Enforcement, Criminal Activity. Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of HIPAA. 

Other Permitted and Required Uses and Disclosures Will Be Made Only with Your Consent, Authorization or Opportunity to Object, unless required by law. 

You may revoke this authorization, at any time, in writing, except to the extent that your medical provider or Replenish has taken an action in reliance on the use or disclosure indicated in the authorization. 

Your Rights: Following are your rights with respect to your protected health information: 

You have the right to inspect and copy your protected health information. Under federal law, however, you may not inspect or copy the following records: information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information. 

You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Replenish is not required to agree to a restriction that you may request. If Replenish believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have the right to use another service provider. 

You have the right to request to receive confidential communications from us by alternative means or at an alternative location. 

You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively, e.g., electronically. 

You may have the right to have Replenish amend your protected health information. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. 

You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. 

We reserve the right to change the terms of this notice and will inform you by mail or email of any changes. You then have the right to object or withdraw as provided in this notice. 

Complaints: You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you for filing a complaint. We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information, if you have any questions concerning or objections to this form, please contact us. 

Associated companies with whom we may do business, such as an answering service or delivery service, are given only enough information to provide the necessary service to you. No medical information is provided. 

We welcome your comments: Please feel free to call us if you have any questions about how we protect your privacy. Our goal is always to provide you with the highest quality services.

Recipient initial

SignaturesThis contract may be signed electronically or in hard copy. If signed in hard copy, it must be returned to the Business for valid record. Electronic signatures count as original for all purposes.

By typing their names as signatures below, both parties agree to the terms and provisions of this agreement.