By clicking "Accept", I hereby authorize the use of my name, email address, home address(es), work address(es), telephone number(s), identifying information relating to my physician(s), hospital(s), pharmacy(ies), and other such healthcare providers, vital signs, weight, medication information, and other such personally identifiable health information to CareGiving App, LLC. I understand that this authorization is voluntary. This authorization may be revoked by a writing signed by me or by my personal representative. If the disclosure authorized herein is not to an entity "covered" under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the privacy regulations issued thereunder, the information that is used or disclosed pursuant to this authorization may be re-disclosed by the receiving persons or entity and the information will no longer be protected by the federal privacy regulations, unless such re-disclosure is expressly prohibited by other state or federal law (e.g., state or federal laws regulating disclosure of information about substance abuse, HIV/AIDS, pregnancy and reproductive conditions, genetic testing, etc.). This authorization shall expire upon the termination of my registration and account with CareGiving App, LLC.