Your Right to Reject Arbitration You may reject this Arbitration provision by sending a written rejection notice to us at: American Express, P.O. Box 981556, El Paso, TX 79998. Go to xxxxxxxxxxxxxxx.xxx/xxxxxx for a sample rejection notice. Your rejection notice must be mailed within 45 days after your first card purchase. Your rejection notice must state that you reject the Arbitration provision and include your name, address, Account number and personal signature. No one else may sign the rejection notice. If your rejection notice complies with these requirements, this Arbitration provision and any other arbitration provisions in the cardmember agreements for any other currently open American Express accounts you have will not apply to you, except for Corporate Card accounts and any claims subject to pending litigation or arbitration at the time you send your rejection notice. Rejection of this Arbitration provision will not affect your other rights or responsibilities under this Claims Resolution section or the Agreement. Rejecting this Arbitration provision will not affect your ability to use your card or any other benefit, product or service you may have with your Account.
Your Rights When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. Get an electronic or paper copy of your medical record U You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. U We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct your medical record U You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. U We may say “no” to your request, but we’ll tell you why in writing within 60 days. Request confidential communications U You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. U We will say “yes” to all reasonable requests. continued on next page ÌVi v *ÀÛ>VÞ *À>VÌVià U *>}i £ Your Rights continued Ask us to limit what we use or share U You can ask us not to use or share certain health information for treatment, payment, or our operations. U We are not required to agree to your request, and we may say “no” if it would affect your care. U If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. U We will say “yes” unless a law requires us to share that information. Get a list of those with whom we’ve shared information U You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. U We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within £Ó Ì Ã° Get a copy of this privacy notice U You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. Choose someone to act for you U If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. U We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated U You can complain if you feel we have violated your rights by contacting us ÕÃ} Ì i vÀ>Ì «>}i £° U You can file a complaint with the U.S. Department of Health and Human -iÀÛVià "vwVi vÀ CÛ ,} Ìà LÞ Ãi`} > iÌÌiÀ Ì Óää I`i«i`iVi AÛiÕi] -°7°] 7>à }Ì] D°C° ÓäÓä£] V>} £nÇÇÈÈÈÇÇx] À visiting xxx.xxx.xxx/xxx/xxxxxxx/xxxxx/xxxxxxxxxx/. U We will not retaliate against you for filing a complaint. ÌVi v *ÀÛ>VÞ *À>VÌVià U *>}i Ó Your Choices For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: U Share information with your family, close friends, or others involved in your care U Share information in a disaster relief situation U Include your information in a hospital directory U Contact you for fundraising efforts If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. In these cases we never share your information unless you give us written permission: U Marketing purposes U Sale of your information U Most sharing of psychotherapy notes In the case of fundraising: U We may contact you for fundraising efforts, but you can tell us not to contact you again. Our Uses and Disclosures How do we typically use or share your health information? We typically use or share your health information in the following ways. Treat you U We can use your health information and share it with other professionals who are treating you.
See Your Right to Reject Arbitration below. For this section, you and us includes any corporate parents, subsidiaries, affiliates or related persons or entities. Claim means any current or future claim, dispute or controversy relating to your Account(s), this Agreement, or any agreement or relationship you have or had with us, except for the validity, enforceability or scope of the Arbitration provision. Claim includes but is not limited to: (1) initial claims, counterclaims, crossclaims and third-party claims;
Right to Grieve Where an employee feels that she has been aggrieved by a decision of the Employer related to promotion, demotion or transfer, the employee may grieve the decision at Step 3 of the grievance procedure in Article 9 of this Agreement within seven (7) days of being notified of the results.
Information About Your Right to Dispute Errors In case of errors or questions about your Card Account, call 0-000-000-0000 or write to Cardholder Services, X.X. Xxx 000000, Xxxxxxxxxxxx, XX, 00000. if you think an error has occurred on your Card Account or if you need more information about a transaction listed on your electronic or written history or receipt. We must allow you to report an error until sixty (60) days after the earlier of the date you electronically access your Card Account, if the error could be viewed in your electronic history, or the date we sent the FIRST written history on which the error appeared. You may request a written history of your transactions at any time by calling 0-000-000-0000 or writing to X.X. Xxx 000000, Xxxxxxxxxxxx, XX, 00000. You will need to tell us:
