TERMS OF SERVICE FOR SYMPHONY - PATIENT VERSION

Effective Date: April 13, 2025

The website, software application, and any related services known as 'Symphony' ("Symphony", "Service") has been developed and is operated by Proton Health ("Proton Health", "Company", "we", "us", "our") and our affiliates.

By accessing and/or using Symphony, you agree to these terms ("Terms").

You confirm that you have the capacity to enter into, be bound by, and deliver and perform the obligations under these Terms. You must not use Symphony if you do not agree to these Terms.

1. INTRODUCTION & ACCOUNTS

1.1 Binding Agreement

These Terms constitute a legally binding agreement between Proton Health, a company registered in England and Wales (Company No. 12578120), with its principal place of business at 7 Bell Yard, London, England, WC2A 2JR, and you, the patient ("Patient", "you", or "your") accessing or using Symphony.

By accessing or using Symphony in any manner, you acknowledge that you have read, understood, and agree to be bound by these Terms in their entirety. If you do not agree to all provisions of these Terms, you must immediately cease accessing and using the Service.

Your healthcare provider's use of Symphony is governed by separate Provider Terms and, where HIPAA applies, by a Business Associate Agreement between Proton Health and your provider.

1.2 Accounts and Registration

Depending on how Symphony is implemented by your healthcare provider, you may be able to access Symphony through a link or code provided by your healthcare provider, or you may need to register for an account. If registration is required, you will need to provide certain information about yourself, which may include your name, contact information, and other details necessary for your healthcare provider to identify you.

1.3 Age Requirements

You must be at least 18 years old or the age of majority in your jurisdiction, whichever is higher, to use Symphony independently.
If you are under the required age, you must have your parent or legal guardian consent to your use of Symphony and agree to these Terms on your behalf.

2. SERVICE DESCRIPTION & PURPOSE

2.1 Symphony Overview

Symphony is a tool that supports the delivery of healthcare services by healthcare providers ("Providers") to patients by providing the following functions:

Pre-Visit Assessment: Collects patient-reported issues via voice/chat interfaces prior to clinical consultations.
Scribe Functionality: May record consultations and generate transcripts/structured notes for your Provider.
Summarized Outputs: Presents summarized information to Providers for review.

2.2 Updates to Symphony Functions

From time to time, we may (in our sole discretion):

Change or update Symphony or its functions; or
Add new functions.

Such updates or new functions may be subject to additional terms as notified to you by Proton Health.

2.3 Non-Medical Purpose

2.3.1 Administrative Tool Only

IMPORTANT: Symphony is explicitly designed and provided as an administrative tool to assist with information collection, organization, and documentation. The Service is NOT:

A medical device as defined by the UK Medicines and Healthcare products Regulatory Agency (MHRA), the US Food and Drug Administration (FDA), or other regulatory bodies;
A diagnostic tool or system;
A clinical decision support system;
A system for autonomous medical assessment; or
A replacement for professional medical judgment.

2.3.2 Informational Outputs Only

All information collected by Symphony and all outputs are provided for informational purposes only and do not constitute:

Medical advice, diagnosis, or treatment recommendations;
Definitive clinical assessments;
Clinical decision guidance; or
A substitute for professional medical expertise.

2.3.3 Provider Review Requirement

IMPORTANT: All information collected by Symphony is subject to review by your healthcare provider before it becomes part of your medical record or is used in your care. Your healthcare provider maintains full responsibility for your care, and Symphony serves only as a tool to assist in collecting and organizing information.

2.4 Term

These Terms commence when you first access Symphony and will continue until terminated by you, your healthcare provider, or Proton Health in accordance with these Terms.

2.5 Electronic Health Record Integration

Symphony may integrate with various Electronic Health Record (EHR) systems used by your healthcare provider. When this integration is active:

Information collected through Symphony may be transmitted to your healthcare provider's EHR system after provider review;
Your provider will determine what information from Symphony should be included in your official medical record;
Information transmitted to the EHR becomes part of your official medical record subject to applicable medical record retention policies;
Your provider remains responsible for the accuracy and completeness of your medical record; and
The transmission of data between Symphony and EHR systems is conducted using secure methods that comply with applicable healthcare privacy and security requirements.

Symphony does not replace your provider's EHR system but serves as a supplementary tool for information collection and organization prior to EHR documentation.

2.6 Third Party Services

Symphony may rely on third-party speech-to-text or cloud-hosting services. Use of those services is subject to their privacy and security commitments, which Proton Health vets before integration.

3. PATIENT OBLIGATIONS AND ACKNOWLEDGMENTS

3.1 Accurate Information

You agree to provide accurate, complete, and truthful information when using Symphony. You understand that your healthcare provider may rely on the information you provide through Symphony to make decisions about your care.

3.2 No Emergency Use

IMPORTANT: Symphony is not designed for emergency situations and should not be used for emergencies. If you are experiencing a medical emergency, you should immediately call your local emergency services number (such as 911 in the US or 999/112 in the UK) or go to the nearest emergency room.

3.3 Provider Responsibility and Limitation of Liability

3.3.1 Provider Review

IMPORTANT: You acknowledge and agree that:

Your healthcare provider must review all information collected through Symphony before it becomes part of your medical record or is used in your care;
Your healthcare provider may not see or review any/all information you provide through Symphony;
Information provided through Symphony but not reviewed by your healthcare provider cannot form the basis for any claim against your healthcare provider;
Symphony does not replace direct communication with your healthcare provider; and
Your healthcare provider maintains sole responsibility for all medical decisions regarding your care.

3.3.2 No Provider Liability for Unreviewed Information

YOU EXPRESSLY WAIVE ANY CLAIM AGAINST YOUR HEALTHCARE PROVIDER BASED ON INFORMATION THAT YOU PROVIDED THROUGH SYMPHONY THAT YOUR PROVIDER DID NOT REVIEW OR INCORPORATE INTO YOUR CARE.

3.3.3 No Medical Advice

You acknowledge that Symphony does not provide medical advice and that all medical decisions must be made by your healthcare provider. Any suggestions, information, or prompts provided by Symphony are not medical advice and should not be treated as such.

3.4 Prohibited Uses

3.4.1 Technical Restrictions

You must not:

Reverse-engineer, decompile, disassemble, or otherwise attempt to derive the source code, algorithms, or methods of Symphony;
Modify, adapt, translate, or create derivative works based on Symphony;
Bypass, circumvent, or attempt to defeat any security measures implemented in Symphony;
Access Symphony through automated means, bots, scripts, or unauthorized third-party applications;
Use Symphony in a manner that imposes an unreasonable load on our infrastructure;
Distribute, sublicense, lease, sell, transfer, assign, or otherwise dispose of your right to use Symphony;
Grant any security interest over Symphony; or
Remove, obliterate or alter any proprietary notice on Symphony.

3.4.2 Content Restrictions

You must not submit, upload, or transmit:

False, misleading, or fraudulent information;
Information about other individuals without their consent;
Content that is offensive, abusive, harassing, or threatening;
Data that contains viruses, malware, or other harmful code; or
Content that infringes intellectual property rights or violates any law.

3.4.3 General Restrictions

You must not:

Do any act that would have an adverse impact on the reputation or standing of Proton Health;
Do any act that is unlawful or is prohibited by any laws applicable to Symphony; or
Expose Symphony, or any data to reasonably avoidable cyber risks.

4. DATA PROTECTION & PRIVACY

4.1 Privacy and Data Use

4.1.1 Privacy Laws Compliance

We comply with applicable privacy laws in respect of any personal information, including without limitation the General Data Protection Regulation (GDPR) in the United Kingdom, the Health Insurance Portability and Accountability Act (HIPAA) in the United States, and applicable state privacy laws such as the California Consumer Privacy Act (CCPA), the Colorado Privacy Act, the Virginia Consumer Data Protection Act, and similar state-level privacy regulations. If you reside in a state with specific privacy rights, you may have additional rights regarding your personal information as provided under those laws. To exercise any rights you may have under these laws (such as access, deletion or correction), please submit a request to [email protected] or through our webform.

4.1.2 Personal Information Collection Notice

We collect, store, use, and disclose personal information about you in order to provide you with use of Symphony and for purposes set out in our Privacy Policy at https://www.iubenda.com/privacy-policy/14842373/full-legal.

Our Privacy Policy explains:

How we store and use, and how you may access and correct your personal information;
How you can lodge a complaint regarding the handling of your personal information; and
How we will handle any complaint.

By providing your personal information to us, you consent to the collection, use, storage, and disclosure of that information as described in these Terms and our Privacy Policy.

4.1.3 Electronic Health Records Compliance

When Symphony is used to create or transmit information that becomes part of an electronic health record, we adhere to applicable requirements under the 21st Century Cures Act and related regulations, including:

Information blocking provisions that prohibit unreasonable restrictions on the access, exchange, or use of electronic health information;
Interoperability standards to enable the secure exchange of electronic health information; and
Requirements related to patient access to their electronic health information.

Symphony is designed to support, but not replace, certified electronic health record technology (CEHRT) used by healthcare providers.

4.2 Data Security

4.2.1 Security Measures

We implement reasonable and appropriate technical, administrative, and physical safeguards to protect your data, including:

Encryption of data in transit and at rest;
Role-based access controls and authentication mechanisms;
Security monitoring and intrusion detection systems;
Regular security assessments and vulnerability testing;
Staff training on security and privacy practices; and
Physical security controls for our infrastructure.
If we become aware of a data breach affecting your protected health information or personal data, we (or your provider) will notify you as required by applicable law.

4.2.2 Your Security Responsibilities

You are responsible for:

Maintaining the confidentiality of any Symphony login credentials provided to you;
Using strong, unique passwords if you create an account;
Ensuring devices used to access Symphony have appropriate security controls;
Logging out of Symphony when not in active use; and
Promptly reporting any suspected security incidents or unauthorized access to your healthcare provider or to us.

4.3 Data Use and Ownership

4.3.1 Provider Access

You understand and agree that information you provide through Symphony will be made available to your healthcare provider and their authorized staff.

4.3.2 De-identified Information

Proton Health may de-identify information that is made available to Proton Health in connection with Symphony and use or disclose such information in a de-identified form for the purposes of:

Improving Symphony functionality;
Research and development of healthcare tools; and
As otherwise described in our Privacy Policy.

You acknowledge that de-identified use may involve disclosure of de-identified information to third parties as part of making Symphony and certain functionality available.

Proton Health will take reasonable steps to ensure that information that is de-identified cannot be reverse-engineered, re-identified, or linked back to you by third parties.

4.3.3 Recordings and Transcripts

If your consultation is recorded using Symphony:

You consent to the recording and transcription of your consultation;
The recording and transcript will be made available to your healthcare provider;
The recording and transcript may be processed by artificial intelligence to create notes and summaries; and
You can request that recording be stopped at any time during your consultation.
If you withdraw consent, any recording made up to that point will be retained or deleted in accordance with your provider's instructions and applicable law.

5. INTELLECTUAL PROPERTY

5.1 Our Intellectual Property Rights

Unless otherwise indicated, we own or license from third parties all rights, title, and interest (including copyright, designs, patents, trademarks, and other intellectual property rights) in Symphony and any material made available through Symphony.

5.2 License to Symphony

Proton Health grants you a limited, non-transferable, non-exclusive license to use Symphony for the duration of these Terms solely for the purpose of supporting the delivery of healthcare services to you by your healthcare provider. You must not use Symphony for any other purpose.

6. LIMITATIONS AND DISCLAIMERS

6.1 Technical Requirements

You acknowledge that you are responsible for ensuring that your devices and internet connection are able to work in conjunction with Symphony.

6.2 No Professional Medical or Healthcare Advice

6.2.1 Administrative Support Only

IMPORTANT: You agree that Symphony is solely for the purposes of supporting administrative processes related to your healthcare. Your healthcare provider must exercise all necessary, and final, professional and medical decisions in relation to your diagnosis, advice, or treatment.

6.2.2 No Medical Device Claim

Symphony is designed as a digital dictation, transcription, and documentation support tool to assist healthcare providers in creating clinical notes.

You further agree and acknowledge that Symphony and related services do not:

Constitute professional medical or healthcare advice, diagnosis, or recommendation of treatment, or replace professional medical advice;
Directly assess, maintain, or improve your physical, mental, or emotional health; or
Directly diagnose or treat your illness or disability.

6.3 No Warranties

6.3.1 "As Is" Service

Symphony is provided strictly on an "as is" and "as available" basis. To the maximum extent permitted by applicable law, the Company expressly disclaims all warranties of any kind, whether express, implied, statutory, or otherwise, including but not limited to:

Warranties of merchantability, fitness for a particular purpose, and non-infringement;
Warranties regarding accuracy, reliability, or completeness of Symphony content;
Warranties that Symphony will meet your requirements or expectations;
Warranties that Symphony will operate without interruption, errors, or security incidents; and
Warranties regarding the quality, accuracy, timeliness, or reliability of outputs.

6.3.2 AI Disclaimer

You acknowledge that the functionalities of Symphony involve the use of artificial intelligence and machine learning. While Proton Health seeks to ensure accuracy of Symphony, due to the probabilistic and rapidly evolving nature of such functions, Symphony may in certain circumstances be inaccurate, incomplete, or inappropriate.

Symphony and related services are provided "as is" without warranty or guarantee of any kind, and we will not be liable for any direct and indirect loss, damage, or expense – irrespective of the manner in which it occurs – which may be suffered due to your use of Symphony.

7. LIMITATION OF LIABILITY

7.1 Cap on Liability

Notwithstanding anything to the contrary in these Terms, the Company's total cumulative liability to you for all claims arising out of or related to these Terms or the use of Symphony, regardless of the form of action or theory of liability, shall be limited to the maximum extent permitted by applicable law.

7.2 Excluded Damages

In no event shall the Company be liable for:

Indirect, incidental, consequential, special, exemplary, or punitive damages;
Lost profits, revenue, business opportunities, or anticipated savings;
Loss of data, goodwill, or reputation;
Cost of substitute services;
Medical malpractice liability or patient claims;
Delays in medical care;
Documentation deficiencies; or
Treatment outcomes.

7.3 Provider Non-Liability

IMPORTANT: You agree that your healthcare provider shall not be liable for the following to the fullest extent permitted by applicable law:

Any information you provide through Symphony that they did not review;
Any technical failures or errors in Symphony;
Any delays in receiving or processing information through Symphony; or
Any decisions made based on information they actually reviewed and incorporated into your care.

7.4 Force Majeure

Neither party shall be liable for any failure or delay in performance due to circumstances beyond their reasonable control, including but not limited to acts of God, natural disasters, pandemic, epidemic, acts of government, acts of terror, civil unrest, labor disputes, failure of telecommunications or internet service providers, or malicious attacks on our systems.

7.5 Jurisdictional Limitations

Some jurisdictions do not allow the exclusion or limitation of certain damages. To the extent any exclusion or limitation is prohibited by applicable law, such exclusion or limitation shall apply only to the maximum extent permitted by law. Nothing in these Terms excludes or limits liability that cannot be excluded or limited under applicable law.

8. SUSPENSION AND TERMINATION

8.1 Suspension

We reserve the right to restrict, suspend, or terminate your access to Symphony without notice (although we will provide prior notice wherever practicable). To the maximum extent permitted by law, we will not be responsible for any loss, cost, damage, or liability that may arise as a result.

8.2 Termination

8.2.1 By Patient

You may terminate your use of Symphony (and accordingly these Terms) by contacting your healthcare provider or, if you have an account, through your account settings.

8.2.2 By Company

We may terminate these Terms if:

We reasonably believe you have breached any of these Terms;
We withdraw Symphony from market; or
We consider it reasonably necessary to comply with applicable law.

8.2.3 By Provider

Your healthcare provider may terminate your access to Symphony at any time at their discretion.

8.3 Effect of Termination

On termination or expiry of these Terms:

The license granted by Proton Health to you will cease and we shall cease providing (and you shall cease using) Symphony and related services;
To the extent permitted by law, we may, in our discretion, delete any data, content, or materials which have been provided to us; and
This will not affect any accrued rights, and rights and obligations which are intended or which by their nature survive termination will continue to have effect.
We will delete or irreversibly de-identify your data within 30 days, except where retention is required by law or our contract with your healthcare provider.

9. GOVERNING LAW & DISPUTES

9.1 Governing Law

These Terms shall be governed by and construed in accordance with the laws of England and Wales, without giving effect to any principles of conflicts of law.

9.2 Dispute Resolution

9.2.1 UK Patients

For Patients based in the United Kingdom:

All disputes arising out of or in connection with these Terms shall be subject to the exclusive jurisdiction of the courts of England and Wales.
Before commencing legal proceedings, parties agree to attempt to resolve disputes through good-faith negotiations for a period of not less than thirty (30) days.

9.2.2 US Patients

For Patients based in the United States:

All disputes arising out of or in connection with these Terms shall shall be resolved by binding arbitration administered by JAMS in New York, NY under its Comprehensive Rules.
The arbitration shall be conducted in English and the arbitrator shall apply the laws of England and Wales.
The arbitrator's decision shall be final and binding on both parties.
Either party may seek enforcement of the arbitrator's award in any court of competent jurisdiction.
Nothing in this section shall prevent either party from seeking injunctive or equitable relief from a court of competent jurisdiction pending arbitration.

9.2.3 Small Claims

Notwithstanding the foregoing, either party may bring an individual action in small claims court for disputes within the jurisdictional limit of such court.

9.3 Class Action Waiver

To the maximum extent permitted by applicable law, all claims must be brought in the parties' individual capacity, and not as a plaintiff or class member in any purported class or representative proceeding. Unless both you and Company agree otherwise, no arbitrator or judge may consolidate more than one person's claims or otherwise preside over any form of a representative or class proceeding.

10. MISCELLANEOUS

10.1 Entire Agreement

These Terms constitute the entire agreement between you and the Company regarding Symphony and supersede all prior and contemporaneous agreements, proposals, or representations, written or oral, concerning its subject matter.

10.2 Severability

If any provision of these Terms is held to be invalid or unenforceable, such provision shall be struck and the remaining provisions shall be enforced to the extent possible.

10.3 No Waiver

Our failure to enforce any right or provision of these Terms will not be considered a waiver of such right or provision.

10.4 Assignment

You may not assign or transfer these Terms or your rights under these Terms, in whole or in part, by operation of law or otherwise, without our prior written consent. We may assign these Terms at any time without notice or consent.

10.5 Contact Information

If you have any questions about these Terms, please contact us at:

Proton Health
7 Bell Yard
London, England, WC2A 2JR
Email: [email protected]

10.6 Changes to these terms

We may update these Terms on 30 days' notice. If you object to a material change, you may stop using Symphony and request deletion of your account.

11. ACKNOWLEDGMENT

BY USING SYMPHONY, YOU ACKNOWLEDGE THAT:

SYMPHONY IS NOT A MEDICAL DEVICE AND DOES NOT PROVIDE MEDICAL ADVICE;
YOUR HEALTHCARE PROVIDER MAY REVIEW ALL INFORMATION COLLECTED THROUGH SYMPHONY BEFORE INCORPORATING IT INTO YOUR MEDICAL RECORD OR USING IT IN YOUR CARE;
YOU ACKNOWLEDGE THAT YOUR HEALTHCARE PROVIDER MAY NOT REVIEW OR BE ABLE TO REVIEW ANY/ALL INFORMATION YOU PROVIDE THROUGH SYMPHONY, AND ONLY INFORMATION ACTUALLY REVIEWED CAN BE INCORPORATED INTO YOUR CARE;
YOU WAIVE ANY CLAIM AGAINST YOUR HEALTHCARE PROVIDER BASED ON INFORMATION YOU PROVIDED THROUGH SYMPHONY THAT YOUR PROVIDER DID NOT REVIEW; AND
YOU HAVE READ, UNDERSTOOD, AND AGREE TO THESE TERMS.

Last Updated: April 13, 2025