Terms of Service

1. Acceptance of Terms

By accessing or using the website, patient portal, telehealth platform, or any services of Bertrand Desilva MD INC. (“we,” “us,” “our,” or the “Practice”), located at bertranddesilvamd.com (the “Website”), including but not limited to browsing the Website, scheduling appointments, attending telehealth consultations, submitting information through forms, communicating with our office or automated systems, or interacting with any digital tools or features we provide, you agree to be bound by these Terms of Service (“Terms”), our Privacy Policy and Notice of Privacy Practices, and our Informed Consent for Telehealth Services (collectively, the “Agreements”).

These Terms constitute a legally binding agreement between you (“you,” “your,” or “Patient”) and Bertrand Desilva MD INC.. If you are accessing or using our services on behalf of a minor patient as a parent or legal guardian, you agree to these Terms on behalf of yourself and the minor patient, and you represent that you have the legal authority to do so.

If you do not agree with any part of these Terms, you must immediately discontinue use of our Website and services.

2. Description of Services

Bertrand Desilva MD INC. is a California medical corporation providing sleep medicine consultations and related healthcare services. Our services include, but may not be limited to:

• Telehealth sleep medicine consultations via a HIPAA-compliant video and audio platform.
• In-person sleep medicine consultations at our physical office location.
• Sleep apnea diagnosis, treatment planning, and ongoing management.
• CPAP and BiPAP therapy management.
• Oral appliance therapy evaluation and coordination with qualified dental providers.
• Dental sleep medicine consultations.
• Ordering and interpretation of home sleep tests (HST) and in-lab polysomnography (PSG).
• Follow-up care, treatment adjustment consultations, and compliance monitoring.
• Prescription of medications and durable medical equipment (DME) related to sleep disorders.
• Coordination with referring physicians, specialists, DME suppliers, and other healthcare providers involved in your care.

2.1 Telehealth Availability

Our telehealth services are available to patients who are physically located in the State of California at the time of their consultation. Telehealth services may also be available to patients physically located in other states where our providers hold active, unrestricted medical licenses. It is your responsibility to inform us of your physical location at the time of each telehealth visit. We reserve the right to decline or discontinue a telehealth consultation if we determine that we are not licensed to provide care in your location.

2.2 In-Person Services

In-person consultations and services are available at our physical office location in Irvine, California. Certain clinical services may require in-person evaluation regardless of your preference for telehealth.

2.3 Scope Limitations

Our services are limited to sleep medicine and related conditions within the scope of our providers' licensure and expertise. We do not provide primary care, emergency medicine, urgent care, mental health counseling, or general medical services outside the scope of sleep medicine. If your condition requires care outside our scope, we will provide appropriate referrals.

3. Eligibility

To use our services, you must meet the following requirements:

3.1 Age

You must be at least eighteen (18) years of age to use our Website and services independently. Patients under the age of eighteen (18) may receive clinical services with the informed consent and supervision of a parent or legal guardian, as described in our Informed Consent for Telehealth Services, Section 14. The parent or legal guardian must agree to these Terms on behalf of the minor patient.

3.2 Location

For telehealth services, you must be physically located in a state where your assigned provider holds an active, unrestricted medical license at the time of your consultation. For in-person services, you must be able to attend our physical office in Irvine, California.

3.3 Identification

You must provide valid government-issued photo identification to verify your identity before receiving clinical services. For minor patients, the parent or legal guardian must provide identification for both themselves and the minor.

3.4 Accurate Information

You agree to provide truthful, accurate, and complete information at all times, including your medical history, current medications, allergies, contact details, insurance information, physical location, and any other information requested by our Practice. You agree to promptly update any information that changes. Providing false, misleading, or incomplete information may result in adverse clinical outcomes, invalid prescriptions, termination of services, or legal consequences.

3.5 Legal Capacity

You represent that you have the legal capacity to enter into these Terms and to consent to healthcare services, or that you are acting as the authorized legal guardian of a minor patient with the legal authority to consent on their behalf.

4. Patient Account and Portal

4.1 Account Creation

We may offer a secure, HIPAA-compliant patient portal for managing your healthcare relationship with our Practice, including accessing medical records, communicating with your care team, viewing test results, and managing appointments. If you create a patient portal account, you are responsible for maintaining the confidentiality of your login credentials and for all activity that occurs under your account.

4.2 Account Security

You agree to:

• Choose a strong, unique password and not share it with others.
• Notify our office immediately if you suspect unauthorized access to your account.
• Not access another patient's account or impersonate another individual.
• Log out of your account when using shared or public devices.
• Maintain the security of the devices and networks used to access your patient portal or telehealth sessions, including installing software updates and using secure internet connections.

4.3 Account Termination

We reserve the right to suspend or terminate your patient portal account at any time for violation of these Terms, security concerns, or inactivity, with notice where practicable. You may request deactivation of your account at any time by contacting our office. Deactivation of your portal account does not affect your medical records, which are retained in accordance with our Privacy Policy.

5. Appointments and Payments

5.1 Scheduling and Prepayment

Appointments are scheduled through our online booking system, by phone, or through other scheduling methods we make available. Full payment for the consultation is required at the time of booking unless other arrangements have been made in advance. No appointment is confirmed until payment has been successfully processed and you receive a confirmation from our office.

5.2 Pricing Transparency

We are committed to transparent pricing. Our current consultation fees are clearly displayed on our Website prior to booking. All fees are denominated in U.S. dollars. If our fees change, the new fees will apply to appointments booked after the effective date of the change. You will always know the cost of your visit before completing your booking.

5.3 Accepted Payment Methods

We accept major credit cards, debit cards, and other payment methods as indicated on our Website. All payment transactions are processed through PCI DSS-compliant payment processors. We do not store your full credit card number on our systems.

5.4 Cancellation and Refund Policy

• Cancellations with 24+ hours' notice: Cancellations made at least twenty-four (24) hours before the scheduled appointment will receive a full refund to the original payment method.
• Late cancellations (less than 24 hours): Cancellations made less than twenty-four (24) hours before the appointment may be subject to a cancellation fee or forfeiture of the prepaid consultation fee.
• No-shows: If you do not appear for your scheduled appointment and do not contact our office, you may be charged the full consultation fee.
• Late arrivals: If you join your telehealth session or arrive at our office more than ten (10) minutes after the scheduled start time, your provider may need to shorten the session or reschedule. Late arrivals do not extend the scheduled session time.
• Practice-initiated cancellations: If we need to cancel or reschedule your appointment for any reason, you will receive a full refund or may reschedule at no additional cost.
• Technical failures: If a telehealth session cannot be completed due to technical issues on our end, you will not be charged. See our Telehealth Consent, Section 7, for the technical failure protocol.

Refunds are processed within seven (7) to ten (10) business days to the original payment method. If you believe you were charged in error, please contact our office within thirty (30) days.

5.5 Insurance

We may provide a detailed receipt or superbill that you can submit to your insurance company for potential out-of-network reimbursement. We do not guarantee that your insurance will reimburse you for our services. Insurance coverage, benefits, deductibles, and reimbursement rates vary by plan and are outside our control. It is your responsibility to verify your insurance benefits, including telehealth-specific coverage, prior to your appointment.

5.6 Additional Services and Third-Party Charges

Diagnostic tests (such as home sleep tests), durable medical equipment (such as CPAP machines), oral appliances, laboratory work, imaging, and prescriptions are not included in the consultation fee and may involve separate charges from third-party providers, suppliers, laboratories, or pharmacies. Our Practice is not responsible for charges assessed by, or billing disputes with, third-party providers.

5.7 Collections

If you have an outstanding balance that remains unpaid after reasonable attempts to collect, we reserve the right to refer your account to a third-party collection agency. We will provide you with written notice and an opportunity to resolve the balance before any account is referred to collections.

6. Telehealth Services

Telehealth services rely on electronic communication technologies that may be affected by factors outside the Practice's control, including internet connectivity, device compatibility, software errors, or platform outages. Telehealth consultations are governed by these Terms, our Informed Consent for Telehealth Services, and our Privacy Policy. By scheduling and attending a telehealth consultation, you acknowledge that you have reviewed and agreed to the Informed Consent for Telehealth Services, which contains detailed information about:

• The nature, benefits, risks, and limitations of telehealth.
• Your rights as a telehealth patient.
• Technology requirements and technical failure protocols.
• Recording and documentation practices.
• Emergency protocols.
• Prescribing practices and limitations.
• Cross-state telehealth considerations.
• AI and automated systems disclosures.
• Patient responsibilities.

In the event of a conflict between these Terms and the Informed Consent for Telehealth Services regarding the delivery of clinical care, the Informed Consent for Telehealth Services shall control.

7. AI and Automated Systems

7.1 Use of AI and Automation

Our Practice may use artificial intelligence (AI) and automated technologies in connection with our Website and services. These may include, but are not limited to:

• AI-Powered Phone Systems: Automated phone agents that may answer incoming calls, assist with appointment scheduling, collect preliminary information, provide general office information, or route your call to the appropriate team member.
• Chatbots and Virtual Assistants: AI-powered tools on our Website or patient portal that may assist with scheduling, general inquiries, navigation, or frequently asked questions.
• Automated Communications: Automated text messages, emails, or phone calls for appointment reminders, follow-up notifications, billing reminders, and other administrative communications.
• Clinical Decision Support: AI-assisted tools may be used to organize or analyze data and assist providers with administrative or analytical tasks. All diagnoses, treatment decisions, and clinical recommendations are made solely by licensed healthcare providers.
• Website Functionality: AI-powered features that may enhance website functionality, search, content recommendations, or user experience.

7.2 AI Limitations and Disclaimers

• AI and automated systems are tools used to support our Practice and improve your experience. They are not a substitute for professional medical judgment.
• AI systems do not provide medical advice, diagnoses, or treatment recommendations. Any health-related information provided by an AI system is for general informational purposes only.
• AI-generated responses may contain errors, inaccuracies, or incomplete information. You should not rely on AI-generated content as a substitute for consultation with your healthcare provider.
• All clinical decisions are made by licensed healthcare providers, not by AI systems.
• We are not liable for any harm arising from your reliance on information provided by AI or automated systems outside of the clinical setting.

7.3 Your Rights

• You will be clearly notified when you are interacting with an AI or automated system rather than a human.
• You have the right to request to speak with a human at any time during an interaction with an AI system.
• You may opt out of automated communications (other than essential appointment-related notices) by contacting our office or following the opt-out instructions in the communication.

7.4 Data and AI Interactions

Interactions with AI and automated systems (including voice recordings, transcriptions, chat logs, and usage data) may be recorded, stored, and used for quality improvement, training, compliance, and operational purposes. These interactions are governed by our Privacy Policy. AI system data that constitutes or contains PHI is subject to all HIPAA protections.

8. Website Use and Acceptable Conduct

8.1 Permitted Use

You may use our Website for its intended purposes: learning about our Practice and services, scheduling appointments, accessing your patient portal, communicating with our office, and engaging with educational content we provide. All use of our Website must comply with these Terms and applicable law.

8.2 Prohibited Conduct

You agree not to:

• Use the Website for any unlawful purpose or in violation of any applicable local, state, federal, or international law.
• Impersonate any person or entity, or falsely represent your identity, age, location, or affiliation.
• Submit false, misleading, or fraudulent information through any form, portal, or communication channel.
• Attempt to gain unauthorized access to any portion of the Website, patient portal, server, database, or any connected systems or networks.
• Introduce viruses, malware, trojans, worms, or other harmful or malicious code.
• Use automated tools (bots, scrapers, spiders, crawlers) to access, monitor, copy, or extract content from the Website without our prior written consent.
• Interfere with or disrupt the operation, security, or performance of the Website or its underlying infrastructure.
• Harvest, collect, or store personal information of other users or patients.
• Use the Website to harass, threaten, defame, or abuse any person, including our staff, providers, and other patients.
• Reproduce, distribute, modify, create derivative works from, publicly display, or commercially exploit any content from the Website without our prior written consent (see Section 12).
• Circumvent, disable, or interfere with any security features or access controls on the Website.

8.3 Enforcement

We reserve the right to investigate any suspected violation of these Terms and to take appropriate action, including suspending or terminating your access to the Website, removing content, reporting illegal activity to law enforcement, and pursuing legal remedies.

9. Patient Submissions and Uploaded Content

9.1 Types of Submissions

You may submit or upload content to our Practice through various channels, including the patient portal, intake forms, contact forms, email, secure messaging, file uploads (e.g., sleep study results, CPAP compliance reports, referral documents, images, insurance cards), and other communication methods we make available.

9.2 Your Representations

By submitting content to our Practice, you represent and warrant that:

• The content is accurate, truthful, and complete to the best of your knowledge.
• You have the legal right to submit the content (e.g., it is your own information, or you have authorization from the individual whose information you are submitting).
• The content does not violate any applicable law, regulation, or third-party right, including intellectual property rights and privacy rights.
• The content does not contain viruses, malware, or other harmful code.

9.3 Use of Submissions

Content submitted in connection with your clinical care becomes part of your medical record and is governed by HIPAA, the CMIA, and our Privacy Policy. We may use submitted content for treatment, payment, healthcare operations, and other purposes described in our Privacy Policy. We do not claim ownership of content you submit, but you grant us a non-exclusive, royalty-free license to use, store, process, and transmit your submissions as necessary to provide our services and comply with applicable law.

9.4 No Obligation to Review

While we process clinical submissions as part of standard care, we are not obligated to review, respond to, or act upon non-clinical submissions (e.g., general inquiries, feedback, suggestions) within any specific timeframe.

10. Medical Disclaimers

10.1 Not Emergency Services

10.2 No Provider-Patient Relationship Without Formal Acceptance

Visiting our Website, submitting an inquiry, or scheduling an appointment does not establish a provider-patient relationship. A provider-patient relationship is established only when you have been formally accepted as a patient by our Practice, completed required intake documentation, and received clinical services from one of our licensed providers.

10.3 Website Content Is Informational Only

The information provided on our Website, including blog posts, educational articles, service descriptions, and frequently asked questions, is for general informational and educational purposes only. Website content does not constitute medical advice, diagnosis, or treatment. It is not a substitute for professional medical judgment. Always consult a qualified healthcare provider regarding any medical condition, symptoms, or treatment options. Do not disregard, delay, or avoid seeking professional medical advice based on information you read on our Website.

10.4 No Guarantee of Outcomes

Medicine is not an exact science. While our providers will exercise their best professional judgment and adhere to the applicable standard of care, we cannot and do not guarantee specific clinical outcomes, treatment results, or that our services will meet your expectations. Individual results vary based on numerous factors, including the nature and severity of your condition, your compliance with treatment recommendations, and other individual health factors.

10.5 Referrals to Third Parties

If our providers refer you to other healthcare providers, specialists, DME suppliers, testing facilities, or other third parties, we are providing a recommendation based on clinical judgment. We do not control, endorse, or guarantee the services, products, quality of care, or billing practices of any third party. You are responsible for evaluating and selecting third-party providers.

10.6 No Medical Advice Through Website Communications

Communications submitted through the Website, contact forms, chat tools, email, or other electronic channels are not continuously monitored and should not be used for urgent medical issues. Submission of a message does not constitute medical advice or establish a provider-patient relationship until reviewed and responded to by a licensed provider within the context of an established clinical relationship.

11. Electronic Communications Consent

11.1 Consent to Electronic Communications

By providing your email address, phone number, or other electronic contact information and agreeing to these Terms, you consent to receive electronic communications from our Practice, including:

• Appointment confirmations, reminders, and scheduling changes.
• Follow-up care instructions and treatment-related notifications.
• Billing statements, payment receipts, and financial communications.
• Practice announcements, updates, and health-related information.
• Responses to your inquiries and requests.
• Automated messages from AI and automated systems (see Section 7).

11.2 Methods of Communication

Communications may be delivered via email, text message (SMS/MMS), phone call (including automated and AI-powered calls), patient portal messages, postal mail, or other methods you have authorized.

11.3 Unencrypted Communications

Standard email and text messaging are not encrypted and carry inherent security risks. We will not transmit detailed Protected Health Information (PHI) via unencrypted email or text message unless you have provided written consent acknowledging these risks. For detailed information on communication privacy, see our Privacy Policy, Section 7.

11.4 Opting Out

You may opt out of non-essential communications (marketing, general health information, practice announcements) at any time by:

• Replying STOP to any text message.
• Clicking the unsubscribe link in any email.
• Contacting our office by phone or email.

You may not opt out of essential communications related to your active care, scheduled appointments, billing, or legal notices, as these are necessary for the provision of services.

11.5 SMS/Text Messaging Program Terms

The following terms apply specifically to SMS/text messaging communications from Bertrand Desilva MD INC.:

• Program Name: Bertrand Desilva MD INC. Patient Communications
• Program Description: Bertrand Desilva MD INC. offers SMS/text messaging to patients and prospective patients for appointment reminders and scheduling confirmations, health service updates and care coordination, follow-up care notifications, and (with separate opt-in consent) educational sleep health content and practice news.
• Opt-Out: You can cancel the SMS service at any time. Simply text “STOP” to the number from which you received messages. Upon sending “STOP,” we will confirm your unsubscribe status via SMS. Following this confirmation, you will no longer receive SMS messages from us. To rejoin, sign up as you did initially through our website forms, and we will resume sending SMS messages to you.
• Help: If you experience issues with the messaging program, reply with the keyword HELP for more assistance, or reach out directly to our office at (888) 886-2126 or info@bertranddesilvamd.com.
• Carrier Liability: Carriers are not liable for delayed or undelivered messages.
• Message and Data Rates: As always, message and data rates may apply for messages sent to you from us and to us from you. Message frequency varies. For questions about your text plan or data plan, contact your wireless provider.
• Privacy: For privacy-related inquiries, please refer to our privacy policy at https://bertranddesilvamd.com/privacy-policy.
• Consent: By opting in to SMS messaging from Bertrand Desilva MD INC., you acknowledge that you have read, understand, and agree to these SMS program terms. Opt-in consent is collected through our website forms at bertranddesilvamd.com/book and bertranddesilvamd.com/contact via clearly labeled, unchecked consent checkboxes that the user must actively select.

12. Intellectual Property

12.1 Ownership

All content on our Website, including but not limited to text, articles, blog posts, graphics, logos, images, icons, photographs, audio, video, software, code, design elements, page layouts, and the overall look and feel of the Website (collectively, “Content”), is the property of Bertrand Desilva MD INC. or its licensors and is protected by United States and international copyright, trademark, trade dress, and other intellectual property laws.

12.2 Limited License

We grant you a limited, non-exclusive, non-transferable, revocable license to access and view the Content on our Website for your personal, non-commercial use in connection with using our services. This license does not include the right to:

• Reproduce, distribute, modify, or create derivative works from any Content.
• Publicly display, perform, or broadcast any Content.
• Use any Content for commercial purposes.
• Remove any copyright, trademark, or other proprietary notices from Content.
• Frame, mirror, or deep-link to our Website or any portion thereof.

12.3 Trademarks

“Bertrand Desilva MD INC.,” “Dr. Bertrand R. Desilva Sleep Medicine,” our logo, and other marks displayed on our Website are trademarks or service marks of Bertrand Desilva MD INC. You may not use any trademark or service mark without our prior written consent.

12.4 DMCA Notice

If you believe that any content on our Website infringes your copyright, you may submit a notice under the Digital Millennium Copyright Act (DMCA) to our designated agent at:

Your notice must include: identification of the copyrighted work, identification of the infringing material with sufficient information for us to locate it, your contact information, a statement of good faith belief that the use is not authorized, a statement of accuracy under penalty of perjury, and your physical or electronic signature.

13. Third-Party Links and Services

13.1 Third-Party Links

Our Website may contain links to third-party websites, applications, or resources for your convenience or reference. These links do not constitute an endorsement, sponsorship, or recommendation of the linked sites or their content, products, or services. We do not control, monitor, or guarantee the accuracy, completeness, legality, or availability of any third-party content. Your use of third-party websites is at your own risk and subject to the terms and privacy policies of those websites.

13.2 Third-Party Services

Our Practice uses third-party services to deliver care, process payments, and operate our business (e.g., telehealth platform, EHR system, payment processors, scheduling tools). Your use of these services may be subject to the third party's own terms of service and privacy policy. For information on how we protect your data in connection with third-party services, see our Privacy Policy, Section 15.

13.3 Third-Party Content

Our Website may reference, summarize, or link to medical research, clinical guidelines, news articles, or other third-party educational content. Such references are for informational purposes only. We do not guarantee the accuracy or completeness of third-party content and are not responsible for any errors, omissions, or conclusions contained therein.

14. Limitation of Liability

14.1 General Limitation

TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, BERTRAND DESILVA MD INC., ITS PHYSICIANS, NURSE PRACTITIONERS, STAFF, OFFICERS, DIRECTORS, AGENTS, AND AFFILIATES (COLLECTIVELY, “PRACTICE PARTIES”) SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES ARISING OUT OF OR RELATED TO YOUR USE OF (OR INABILITY TO USE) OUR WEBSITE, PATIENT PORTAL, OR SERVICES, INCLUDING BUT NOT LIMITED TO:

• Interruptions, failures, or degradation of telehealth technology, internet connectivity, or electronic communications.
• Unauthorized access to, alteration of, or loss of your data or transmissions.
• Errors, omissions, inaccuracies, or outdated information in Website content, blog posts, educational materials, or automated communications.
• Delays or interruptions in accessing our Website or services.
• Actions or omissions of third-party service providers, including telehealth platform vendors, payment processors, DME suppliers, laboratories, pharmacies, or referring providers.
• Your reliance on information provided by AI or automated systems (see Section 7).
• Loss of data, revenue, profits, or business opportunities.

14.2 Cap on Liability

TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, THE AGGREGATE LIABILITY OF PRACTICE PARTIES FOR ALL CLAIMS ARISING OUT OF OR RELATED TO THESE TERMS OR YOUR USE OF OUR WEBSITE (EXCLUDING CLINICAL SERVICES) SHALL NOT EXCEED THE TOTAL AMOUNT YOU PAID TO OUR PRACTICE IN THE TWELVE (12) MONTHS PRECEDING THE EVENT GIVING RISE TO THE CLAIM, OR ONE THOUSAND DOLLARS ($1,000), WHICHEVER IS GREATER.

14.3 Exceptions

NOTHING IN THESE TERMS SHALL LIMIT OR EXCLUDE LIABILITY FOR:

• Gross negligence or willful misconduct.
• Medical malpractice or professional negligence in the delivery of clinical care.
• Fraud or intentional misrepresentation.
• Death or personal injury caused by negligence.
• Any liability that cannot be limited or excluded under applicable California or federal law.

14.4 Essential Basis

THE LIMITATIONS AND EXCLUSIONS IN THIS SECTION REFLECT A REASONABLE ALLOCATION OF RISK BETWEEN YOU AND OUR PRACTICE AND ARE AN ESSENTIAL BASIS OF THE BARGAIN BETWEEN US. OUR PRACTICE WOULD NOT PROVIDE OUR WEBSITE OR SERVICES TO YOU WITHOUT THESE LIMITATIONS.

15. Warranty Disclaimers

15.1 Website Provided “As Is”

OUR WEBSITE, PATIENT PORTAL, AND ALL CONTENT, FEATURES, TOOLS, AND FUNCTIONALITY THEREIN ARE PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED. TO THE FULLEST EXTENT PERMITTED BY LAW, WE DISCLAIM ALL WARRANTIES, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ACCURACY, AND TITLE.

15.2 No Warranty of Availability

We do not warrant that our Website or services will be available at all times, uninterrupted, secure, error-free, or free of viruses or other harmful components. We do not warrant that defects will be corrected or that our servers are free of harmful code.

15.3 Clinical Services Distinguished

The disclaimers in this Section 15 apply to our Website and digital services, not to the delivery of clinical care. Our licensed providers adhere to the applicable standard of care in the delivery of clinical services. Nothing in these Terms is intended to disclaim professional obligations owed to you as a patient under applicable law.

16. Indemnification

16.1 Your Obligation

To the fullest extent permitted by applicable law, you agree to indemnify, defend, and hold harmless the Practice Parties from and against any and all claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys' fees and court costs) arising out of or related to:

• Your breach of these Terms or any other Agreement.
• Your violation of any applicable law, regulation, or third-party right.
• Your submission of false, misleading, or inaccurate information.
• Your misuse of our Website, patient portal, or services.
• Your negligence or willful misconduct.
• Any content you submit to our Practice, to the extent it infringes any third-party right.
• Your failure to comply with your patient responsibilities, including providing accurate location information for telehealth visits.

16.2 Limitations

This indemnification obligation does not apply to claims arising from our gross negligence, willful misconduct, medical malpractice, or any liability that cannot be indemnified under applicable law.

17. Dispute Resolution

17.1 Informal Resolution

Before initiating any formal legal proceeding, you agree to first contact our Practice in writing (by email or mail) to describe your concern and allow us a reasonable opportunity to resolve it. We will make good-faith efforts to resolve your concern within thirty (30) days of receiving your written notice.

17.2 Mediation

If informal resolution is unsuccessful, either party may initiate non-binding mediation before a mutually agreed-upon mediator in Orange County, California. Each party shall bear its own costs and share equally in the mediator's fees. Mediation shall be completed within sixty (60) days of the request unless extended by mutual agreement.

17.3 Governing Law

These Terms shall be governed by and construed in accordance with the laws of the State of California, without regard to its conflict of law principles.

17.4 Jurisdiction and Venue

Any disputes arising from these Terms or your use of our Website or services that are not resolved through informal resolution or mediation shall be resolved exclusively in the state or federal courts located in Orange County, California. You consent to the personal jurisdiction and venue of such courts.

17.5 Medical Malpractice Claims

Nothing in this dispute resolution section is intended to limit, waive, or alter your rights to pursue a medical malpractice claim under California law, including the Medical Injury Compensation Reform Act (MICRA). Medical malpractice claims are subject to separate legal requirements, including specific statutes of limitations and notice provisions. If you believe you have a medical malpractice claim, you should consult with a qualified attorney.

17.6 Small Claims Court

Nothing in these Terms prevents either party from seeking relief in small claims court for disputes within the jurisdictional limits of that court.

18. Termination

18.1 Termination by You

You may stop using our Website at any time. If you wish to terminate your patient relationship with our Practice, please contact our office in writing. We will provide you with information about transferring your records to another provider and fulfilling any outstanding obligations.

18.2 Termination by Us

We reserve the right to suspend or terminate your access to our Website, patient portal, or services at any time, with or without cause, including but not limited to:

• Violation of these Terms or any other Agreement.
• Providing false, misleading, or fraudulent information.
• Abusive, threatening, or harassing conduct toward our staff, providers, or other patients.
• Failure to pay outstanding balances after reasonable notice.
• Non-compliance with treatment plans, recommendations, or office policies that materially impairs the provider-patient relationship.
• Circumstances where continuing care is not in your best medical interest or is outside our clinical capabilities.

18.3 Continuity of Care

If we terminate the provider-patient relationship, we will provide reasonable notice (except in cases of threatening or dangerous behavior) and continue to provide emergency care for a reasonable period (typically thirty (30) days) to allow you to establish care with another provider. We will assist with transferring your records to a new provider upon your written request.

18.4 Survival

Sections of these Terms that by their nature should survive termination shall survive, including but not limited to Sections 10 (Medical Disclaimers), 12 (Intellectual Property), 14 (Limitation of Liability), 15 (Warranty Disclaimers), 16 (Indemnification), 17 (Dispute Resolution), and 22 (Governing Law).

19. Accessibility

We are committed to ensuring that our Website, patient portal, and telehealth services are accessible to individuals with disabilities in compliance with the Americans with Disabilities Act (ADA), Section 508 of the Rehabilitation Act, and the Web Content Accessibility Guidelines (WCAG) 2.1 Level AA. If you experience any accessibility barriers or require accommodations when using our Website or services, please contact our office at (888) 886-2126 or info@bertranddesilvamd.com, and we will work with you to provide the information or service you need in an accessible format.

20. California-Specific Provisions

20.1 CCPA/CPRA Acknowledgment

If you are a California resident, you have specific rights regarding your personal information under the California Consumer Privacy Act, as amended by the California Privacy Rights Act (CCPA/CPRA). For detailed information about your California privacy rights, including the right to know, delete, correct, and opt out, please see Section 11 of our Privacy Policy.

20.2 California Online Privacy Protection Act (CalOPPA)

In accordance with CalOPPA, we disclose how we respond to “Do Not Track” signals and whether third parties collect personal information about your online activities. For details, see our Privacy Policy, Section 11.9.

20.3 Automatic Renewal Disclosures

We do not currently offer subscription-based services subject to California's automatic renewal law (Cal. Bus. & Prof. Code § 17600 et seq.). If we offer such services in the future, we will provide clear and conspicuous disclosures regarding the automatic renewal terms, cancellation policy, and pricing in compliance with California law before you enroll.

21. General Provisions

21.1 Entire Agreement

These Terms, together with our Privacy Policy and Informed Consent for Telehealth Services, constitute the entire agreement between you and Bertrand Desilva MD INC. regarding your use of our Website and services, and supersede all prior or contemporaneous agreements, understandings, and communications, whether written or oral, regarding the same subject matter.

21.2 Severability

If any provision of these Terms is held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, the invalidity of that provision shall not affect the validity or enforceability of any other provision. The invalid provision shall be modified to the minimum extent necessary to make it valid and enforceable while preserving its original intent, or, if modification is not possible, it shall be severed from these Terms.

21.3 Waiver

Our failure to exercise or enforce any right or provision of these Terms shall not constitute a waiver of that right or provision. No waiver shall be effective unless made in writing and signed by an authorized representative of our Practice. A waiver of any provision on one occasion shall not be construed as a waiver of that provision on any subsequent occasion.

21.4 Assignment

You may not assign or transfer your rights or obligations under these Terms to any third party without our prior written consent. We may assign or transfer our rights and obligations under these Terms without restriction.

21.5 Force Majeure

We shall not be liable for any failure or delay in performing our obligations under these Terms to the extent that such failure or delay is caused by circumstances beyond our reasonable control, including but not limited to natural disasters, pandemics, epidemics, public health emergencies, acts of government, regulatory changes, war, terrorism, civil unrest, labor disputes, power outages, internet or telecommunications failures, cyberattacks, or other events of force majeure. We will make reasonable efforts to resume performance as soon as practicable and will notify you of any material delays.

21.6 Headings

Section headings in these Terms are for convenience only and shall not affect the interpretation or construction of any provision.

21.7 No Third-Party Beneficiaries

These Terms are for the benefit of you and Bertrand Desilva MD INC. only. No third party is intended to be, or shall be deemed to be, a beneficiary of these Terms.

21.8 Notices

Any notice required or permitted under these Terms shall be delivered to our Practice at the contact information provided in Section 23. Notices to you will be delivered to the email address or mailing address on file with our Practice. Notices are deemed received upon delivery for personal delivery, three (3) business days after mailing for postal mail, and upon transmission for email.

22. Changes to Terms

We reserve the right to modify these Terms at any time. When we make changes:

• The revised Terms will be posted on this page with an updated “Last Updated” date.
• For material changes that significantly affect your rights or obligations, we will make reasonable efforts to provide advance notice via email, Website banner, or patient portal notification.
• Your continued use of our Website or services after the revised Terms are posted constitutes your acceptance of the changes.
• If you do not agree with any changes, you must discontinue use of our Website and services.

We encourage you to review these Terms periodically.

23. Contact Information

If you have any questions, concerns, or requests regarding these Terms of Service, please contact us: