E-SIGN Act Disclosure Agreement
Effective Date: September 1, 2024
Please read this E-Sign Disclosure and Consent Agreement carefully and retain a copy for your records.
This E-Sign Disclosure and Consent Agreement ("Agreement") applies to all communications, disclosures, notices, and forms ("Communications") that we provide to you electronically in connection with your transactions and interactions with America West Placement Inc., and its business associates.
1. CONSENT TO USE ELECTRONIC RECORDS AND SIGNATURES
By agreeing to this Agreement, you consent to the use of electronic signatures, records, and communications in place of physical documents and handwritten signatures. This consent applies to:
- Authorizations for disclosure of health information
- Legal agreements related to care placement
- Service agreements and other forms necessary for providing services
2. ELECTRONIC DELIVERY OF COMMUNICATIONS
We will provide Communications to you electronically through:
- Email or secure messaging system
- Documents available for download on our website or secure portal
You agree that such electronic delivery of Communications is acceptable, and that all electronic signatures are equivalent to wet-ink signatures on physical documents.
3. RIGHT TO WITHDRAW CONSENT
You may withdraw your consent to receive electronic Communications at any time. To do so, please notify us in writing at support@americawestplacement.com. Please be aware that withdrawing your consent may delay the processing of your requests or prevent us from providing certain services to you.
4. HARDWARE AND SOFTWARE REQUIREMENTS
To access and retain electronic Communications, you must have the following:
- A computer, tablet, or smartphone with internet access
- A web browser that supports secure connections (e.g., Chrome, Firefox, Safari)
- Software capable of viewing PDF documents (e.g., Adobe Reader)
- A valid email account
5. PAPER COPIES OF ELECTRONIC COMMUNICATIONS
You may request a paper copy of any electronic Communications by contacting us at support@americawestplacement.com. We reserve the right to charge a fee for providing paper copies.
6. UPDATING YOUR CONTACT INFORMATION
You must provide us with accurate and up-to-date contact information, including your email address, to receive electronic Communications. If your contact information changes, please notify us immediately by contacting support@americawestplacement.com.
7. YOUR AFFIRMATIVE CONSENT
By selecting "I agree" or providing your electronic signature, you consent to the terms of this Agreement and agree to conduct business electronically with us. You further confirm that you meet the necessary hardware and software requirements to receive, view, and retain electronic Communications.
