Island Family Surgical Care Center LLC

Terms of Service, Privacy Policy, and Text Messaging Consent

Last Updated: [10/14/2025]
Address: 411 Huku Lii Place, Suite 304, Kihei, HI 96753
Phone: (808) 868-2277; Fax: (808) 439-6060
Website: https://islandfamilysurgeon.com
Email: contact@islandfamilysurgeon.com

1. TERMS OF SERVICE

1.1 Introduction

Welcome to Island Family Surgical Care Center LLC (“we,” “our,” or “us”). By using our website, services, or communication systems—including text messaging, phone, or email—you agree to these Terms of Service (“Terms”).
If you do not agree, please do not use our services.

1.2 Services

Our website and communication systems are provided for informational and administrative purposes. Messages and content may include appointment confirmations, care coordination, and wellness updates. These do not replace medical advice.

1.3 Credit Card Policy

All patients are required to have a valid credit card on file in order to receive services, even if they typically do not have a co-pay or share of cost. This ensures smooth billing and reduces administrative delays.

1.4 Acceptable Use

You agree to use our services responsibly and lawfully. You may not:

Use our site or systems for fraudulent, illegal, or abusive activity.
Attempt to gain unauthorized access to our servers or systems.
Transmit viruses, spam, or misleading information.

1.5 Limitation of Liability

We are not responsible for any delays, losses, or damages caused by third-party systems, mobile carriers, or internet providers.
Use of our services is at your own discretion and risk.

1.6 Updates to These Terms

We may revise these Terms at any time. Updates will be posted on this page with a new “Last Updated” date. Continued use of our services indicates acceptance of the new Terms.

2. PRIVACY POLICY

2.1 Overview

We respect your privacy and are committed to protecting your personal and medical information in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable laws.

2.2 Information We Collect

We may collect:

Contact information (name, address, phone number, email)
Demographic and insurance information
Medical details relevant to your care
Automatically collected website data (IP, device, browser)
Communication preferences and text message interactions

2.3 How We Use Your Information

We use information to:

Schedule appointments and send reminders
Coordinate your care and communicate updates
Process billing and insurance
Improve our services and patient experience
Comply with legal and regulatory obligations

We do not sell or rent your data.

2.4 Information Sharing

We may share your data only as needed for:

Treatment: Coordination with other healthcare providers.
Payment: Insurance and billing purposes.
Healthcare Operations: Quality review, compliance, and audits.
Legal Requirements: As required by law, subpoena, or public health authority.

All partners and vendors handling PHI are bound by Business Associate Agreements (BAAs).

2.5 Data Security

We use administrative, physical, and technical safeguards (including encryption and access controls) to protect your data.
While we take reasonable precautions, electronic transmission always carries some risk.

2.6 Cookies and Analytics

Our website may use cookies or analytics tools to improve functionality. You can disable cookies in your browser if preferred.

2.7 Your Rights

You have the right to:

Access your medical records
Request corrections or restrictions
Withdraw consent for communications
File a privacy complaint

2.8 Retention

We retain records only as long as necessary for care, billing, and compliance with federal and state retention laws.

3. TEXT MESSAGING OPT-IN POLICY

3.1 Purpose

To improve patient communication, Island Family Surgical Care Center LLC offers an optional text messaging service for appointment reminders, limited care instructions, and office updates.

3.2 Message Types

You may receive:

Appointment reminders or confirmations
Pre- and post-procedure instructions
Health check-ins or limited care coordination
Office closures, schedule changes, or updates
Occasional wellness or event messages

No detailed medical information will be sent unless specifically authorized.

3.3 Message Frequency and Fees

Message frequency: Typically 1–5 per month
Standard message and data rates may apply
Message timing may vary based on appointment activity

3.4 Opt-In Process

You are automatically opt-in if you agree to services from us or by:

Signing this consent form
Checking the consent box during online registration
Providing verbal consent while scheduling an appointment
Texting a keyword (e.g., “START”) to our secure line

By agreeing to receive services from us, you are opted in and you confirm ownership or authorization of the provided phone number.

3.5 Opt-Out Process

You may opt out at any time by:

Replying STOP to any message
Calling our office at (808) 868-2277
Emailing frontdesk@islandfamilysurgeon.com with “STOP TEXTS” in the subject line

After opting out, you will no longer receive text messages, but may still receive calls or emails for essential care coordination, but this may make it difficult to communicate pertinent or important information.

You may text HELP anytime for assistance.

3.6 Privacy and HIPAA Compliance

We comply with HIPAA regulations to protect your information.
All text messages are sent through secure, HIPAA-compliant systems. Messages will contain limited PHI necessary for care coordination only.

3.7 Limitation of Liability

We are not liable for delayed or undelivered messages caused by your mobile carrier.
Please keep your phone number current to ensure timely communication.

4. TEXT MESSAGING CONSENT FORM

Patient Name: _________________________________________
Date of Birth: ______________________
Mobile Number: ______________________
Email: ______________________

Please read and initial each statement:

☐ _____ I authorize Island Family Surgical Care Center LLC to send me appointment reminders, follow-up instructions, and limited healthcare communications via text message (SMS/MMS).

☐ _____ I understand that message and data rates may apply and frequency may vary.

☐ _____ I understand that texts may include limited protected health information necessary for scheduling and coordination of care.

☐ _____ I understand that text messaging is not intended for emergencies. For urgent concerns, I will call 911 or contact the office directly.

☐ _____ I understand that I may opt out at any time by replying STOP or contacting the office.

☐ _____ I confirm that I am the authorized owner/user of the mobile number provided.

Patient Signature: _______________________________
Date: _____________________

Office Use Only:
Staff Initials: _______ | Date Received: ___________

5. Revocation of Consent

You may revoke consent at any time by phone, email, or in writing.
Once revoked, you will no longer receive text communications, but this may make it difficult for us to reach you and vice versa as texting is our main line of communication with patients.

6. Contact Information

Island Family Surgical Care Center LLC
411 Huku Lii Place, Suite 304
Kihei, HI 96753
Phone: (808) 868-2277 ; Fax: (808) 439-6060
Email: contact@islandfamilysurgeon.com
Website: https://islandfamilysurgeon.com