Terms of Service

1. What AccurBeat includes

AccurBeat is a self-pay, at-home electrocardiogram (ECG) study, often called a Holter study or test, lasting approximately three days (the "Service"). You wear a small recording device with adhesive electrodes on your chest. A configured phone supplied with the kit helps transmit the recording for later analysis. The Service includes the clinical eligibility review, a physician's order if appropriate, the loaned kit and standard shipping in both directions, technical support, a physician-signed report and one results consultation with the Practice, as described in Section 5.

Clinical services are provided by PCCL (Medicina Exclusiva) LLC, a Puerto Rico limited liability company, doing business as Medicina Exclusiva, an independent, physician-owned medical practice (the "Practice"). The Practice determines eligibility, orders the study, interprets the recording, signs the final report and provides the results consultation and clinically appropriate follow-up. The Practice and its treating professionals must be authorized to provide care in the state where you are physically located. The Practice is not a party to these Terms. Its clinical consent forms and agreements govern your medical relationship with it. Neither the Practice nor its physicians are employees or agents of Direct or Inc., and you acknowledge that you are relying solely on the Practice—and not Direct or Inc.—for all medical judgment, interpretation, and clinical care.

The recording is analyzed using AccurECG 2.0, Inc.'s FDA-cleared ECG analysis software under 510(k) K252361, and reviewed by trained cardiac technicians before physician interpretation and sign-off. The software and technicians operate strictly as administrative and technical support for the Practice under its clinical protocols to prepare technical input for the physician; they do not perform independent clinical triage, diagnosis, or treatment, and technical review occurs only after your recording data is received for processing. FDA clearance of the software does not guarantee a particular outcome for your study.

The ECG recording device is supplied for use after a physician orders the study. The phone is supplied to support the study and data transmission. Use the kit only as directed in its instructions and by the Practice. Direct is not your physician and does not substitute its judgment for that of the Practice.

2. No live monitoring or emergency response

No one watches your heart rhythm in real time through this Service. The kit and Service do not provide emergency alarms, continuous clinical surveillance or an emergency response service. Your recording is collected for later review. Although the supplied phone may transmit recording segments wirelessly during your study to facilitate data transfer, neither the software, technicians, nor the Practice reviews transmitted data on a real-time or daily basis during your wear period. During its business hours, Direct's Support team may check whether data is being received from the monitor and, if it has stopped, may contact you so that the connection can be restored. This check concerns data transmission only. It is not a review of your heart rhythm, no one looks at your recording until your study ends, and it may not catch every interruption, so keep the phone charged and near you and follow the kit instructions. Review begins only after your study period ends and a complete, usable recording is available.

If you have chest pain, fainting, severe shortness of breath or other symptoms that may be an emergency, call 911 or go to the nearest emergency department. Do not wait for a message, your report or your results consultation. For other new or worsening symptoms, contact the Practice or your usual clinician promptly. Support and secure messages are not emergency channels.

If a potentially urgent finding is identified <u>post-study</u> during technical or physician review under the Practice's clinical protocols, it is referred to the Practice under its clinical procedures. The Practice is responsible for assessing the finding, attempting to contact you and giving appropriate clinical guidance. Keep your contact information current and respond promptly to clinical outreach. This process does not provide live monitoring. The absence of a call or message does not mean your heart rhythm is normal.

3. Eligibility and accurate information

You may order only if all of the following are true:

• You are at least 22 years old and can enter into a binding agreement.

• You are ordering for yourself and will be the person who completes the health intake, wears the device and receives the clinical services. Another person may help you with accessibility, technology or returning the kit, but may not undergo the study in your place.

• Your delivery address is in the service area displayed at checkout. You are physically located in a state where the Practice and treating physician are authorized to provide your care when the intake evaluation and each clinical interaction occur.

• You are not enrolled in Medicare, including Medicare Advantage, or Medicaid, including a Medicaid managed care plan. AccurBeat does not currently accept these beneficiaries.

• You understand that this is a self-pay purchase and are not relying on us to bill an insurer or government program.

• You can follow the kit instructions, use the required communication channels with any reasonable accommodation arranged for you, and provide complete and accurate identity, contact, location and health information.

• You agree to receive automated service text messages from Direct about your order, kit and study at the mobile phone number you provide, sent through our text messaging service provider (currently Spruce Health). These messages are the primary way we keep your study on track; they are not marketing messages. Message frequency varies with your study, and message and data rates may apply. Section 12 has more detail.

Tell the Practice your actual location when requested and before traveling during the study or a results consultation. A delivery address in our service area does not authorize clinical care in another state. A clinician may postpone an interaction or recommend local care if you are in a state where that clinician cannot treat you.

If any eligibility statement is incorrect, do not order. If you discover a mistake or your eligibility or coverage changes before the Service is completed, notify Support and the Practice promptly. Further elective services may be paused or canceled, with payments addressed under Section 8 and applicable law. If care has begun, the Practice will determine appropriate follow-up and any safe transition of care.

A waitlist does not reserve a study or create a charge. We do not require a payment card merely to join the waitlist.

4. Clinical review and separate consent

After you order, the Practice asks you to complete a health questionnaire and separately consent to telehealth and the proposed clinical services. Its clinical consent and privacy notice are available from the Practice. Accepting these Terms does not replace clinical informed consent or an authorization that privacy law requires separately.

The Practice reviews complete intakes in the order received. Review times vary with the physician’s workload and with whether more information is needed, and the Practice will notify you by text when the physician has made a decision. You are not charged until the physician orders your study, and you may cancel at any time before then without charge. A physician may need additional information or a telephone or video evaluation, may decide that the study is unsuitable, or may recommend an in-person evaluation or another form of care. Clinical eligibility is determined by the Practice alone. An online order and payment authorization do not guarantee that a physician will order a study.

If the physician declines to order the study, Direct deletes the payment information. If a charge has already been made in error, Direct refunds it. Your bank controls when a refund appears in your account.

The Practice maintains your clinical record and is solely responsible for its professional services as an independent medical provider. Direct can help with administrative questions and connecting you to the Practice. Questions about symptoms, skin reactions, diagnosis, treatment and results belong with the Practice or another qualified clinician.

5. Price and included services

The founding price is $299 per study for orders accepted through March 31, 2027 (the "Service Price"), including any tax we are required to collect on the included Service. Any price for a later order will be displayed before you authorize payment. A later price change does not affect an order already accepted. The receipt will identify any included tax as required by law.

The Service Price includes the eligibility review, physician order if appropriate, the loaned kit, standard delivery and prepaid return, technical support, technical analysis, physician interpretation and signed report, and one routine results consultation with a physician of the Practice. There is no subscription, automatic renewal or recurring study charge. Direct administers the checkout and payment for this purchase. The included professional services remain the responsibility of the Practice.

The results consultation is ordinarily scheduled for up to 15 minutes and has no additional charge to you. The Practice will make reasonable efforts to arrange it and explain the report. The scheduled duration does not limit a physician's clinical judgment or excuse clinically necessary communication about the study. Additional time needed to explain the report or address an urgent study finding will not create an additional patient charge. The Practice has agreed with Direct that it will not charge you for the included services. Any other medical care from the Practice is a separate arrangement between you and the Practice.

You may decline the consultation. Doing so does not prevent delivery of your report or clinically necessary communication and does not, by itself, entitle you to a partial refund. If you miss an appointment, contact the Practice to reschedule. These Terms do not authorize a separate no-show fee.

The only additional equipment charge authorized by these Terms is the $299 Kit Charge described in Section 9. There are no undisclosed routine charges from Direct or the Practice for the included Service. If you cancel after the kit ships, Direct retains $100 of the Service Price as described in Section 8.

Self-pay and receipts. We do not bill health insurance, Medicare, Medicaid or another benefit program, or submit insurance claims for you, except where law requires corrective action. We provide a receipt or administrative summary of the actual services and charges. You may ask your health savings account (HSA) or flexible spending account (FSA) administrator whether an expense qualifies. We do not guarantee tax treatment, eligibility or reimbursement, and do not provide insurance coding or claims advice. A receipt is not an insurance claim or reimbursement approval.

Good faith estimates. You may have a right to a good faith estimate of expected health care charges under applicable law. The Practice is responsible for estimates and notices required for its professional services, and Direct remains responsible for any legal requirements applicable to it. Support can help route a request. These Terms, the advertised price and your receipt do not replace an estimate or notice required by law or limit a statutory right to dispute a medical bill.

6. Payment authorization

At checkout, you provide a payment card through our payment processor, currently Stripe. Direct saves your card securely with Stripe and charges the checkout total only after the physician orders your study and sends you a receipt electronically.

If the physician does not order the study, or you cancel before it is ordered, Direct deletes the payment information. We do not require you to provide card details in a text message or ordinary email.

By placing an order, you authorize Direct and its payment processor to charge the checkout total as described above. This authorization includes the Kit Charge described in Section 9, which is disclosed at checkout. Direct keeps your card on file for that purpose. By placing an order, you authorize Direct to charge the Kit Charge to that card if it applies under Section 9. Authorizing a card does not permit unrelated or recurring charges.

Contact Support promptly about a suspected payment error. Nothing in these Terms waives rights you have to dispute a charge with your card issuer or under applicable law.

7. Shipping and expected timing

"Business Day" means Monday through Friday, excluding U.S. federal holidays. Times stated in these Terms are Eastern Time unless otherwise indicated.

Direct normally ships the kit by USPS within one Business Day after the physician orders the study and all required shipping information is complete. Any different expected shipping date will be shown before you order or agreed with you. Tracking and delivery updates are sent using your selected communication channels. A signature is not normally required. Give us an address where the package can be received safely, and contact Support promptly if it does not arrive or arrives damaged.

If we cannot ship by the stated date, we will notify you, provide a revised date or explain that one is not yet known, and give you the choice to agree to the delay or cancel for a full refund. If you do not agree to the delay, we cancel and refund the order. You may also cancel at any time before shipment under Section 8, including if shipment has not occurred within five Business Days after the physician's order.

Plan to start within one day after delivery, unless the Practice instructs otherwise, and follow the prescribed recording period. Contact Support and the Practice if you cannot start as planned. Carrier transit times and the timing of clinical review can vary.

Your signed report is normally available within three Business Days after Direct receives the returned kit and confirms that the recording is complete and usable. This is our normal performance, not a guarantee; Section 8 explains what happens if we are late. Your report is prepared from the complete recording stored on the recording device, which we retrieve after the kit is returned. Data transmitted during your study is used to check the connection and may be incomplete, so the report cannot be prepared until the recording device is back with us. If the recording device is not returned, no report can be prepared or delivered, the included results consultation cannot take place, and the Service Price is not refunded, because the physician review, the kit and the shipping have already been provided. If you return the recording device late, we retrieve the recording and the Practice prepares the report if the recording is still complete and usable, and any Kit Charge collected for the recording device is reversed as described in Section 9. If the recording device is returned but another item is not, such as the phone or the charger, the report is still prepared and the Kit Charge in Section 9 applies to the missing item. Overall timing from order to results depends on the physician’s review, shipping, the quality of your recording and your completion of the required steps.

These are expected timeframes, not guarantees of a clinical outcome. If there is a substantial delay, we will explain the next steps and an expected completion time when one is available. Section 8 explains your remedies if we cannot complete the purchased Service.

8. Cancellations and refunds

Contact Support using Section 23 to cancel or request a refund. This Section is the refund policy for the Service. You may request a written copy without charge.

Before the physician orders the study. No Service Price is charged. If a charge was made in error, it is refunded.

After the physician orders the study and before shipment. You receive a full refund.

After shipment. If you cancel after the kit ships, Direct refunds $199 of the Service Price, retaining a $100 cancellation fee, which covers shipping both ways, handling and the physician’s review of your intake, all of which have already been incurred. Direct initiates the refund within seven Business Days after the complete kit is received back with the recording device unused and the reusable items in the condition described in Section 9, ordinary wear excepted. If Direct does not receive the complete kit within the return period in Section 9, Direct still refunds the Service Price less the cancellation fee, and a Kit Charge under Section 9 applies in addition to the cancellation fee. If an item is received later in working condition, Direct reverses the Kit Charge for that item as provided in Section 9.

A kit lost before delivery. Direct offers a replacement at no charge. You may instead cancel for a full refund if a replacement cannot be delivered within a reasonable revised timeframe acceptable to you. You are not charged for a kit you did not receive.

An unusable recording. The Practice determines whether the recording supports a clinically usable report. If it does not, we offer one repeat study at no additional charge, if the Practice considers a repeat appropriate. You may decline the repeat and receive a full refund. If a repeat is unsuitable or also unusable, you receive a full refund. Any separate responsibility for loss or damage to the kit is governed by Section 9.

Stopping early. You may stop wearing the device. If the Practice directs you to stop, follow its instructions. The Practice will interpret the available recording if clinically appropriate. A shorter recording does not automatically require a refund if a usable signed report and the included consultation can still be provided. If the recording is unusable, the preceding paragraph applies. Direct does not determine clinical adequacy to avoid a refund.

Service we cannot complete. If we or the Practice cannot provide the purchased Service for a reason on our side, including a service closure, we provide a full refund. For a substantial delay on our side, if we cannot complete the remaining Service within a reasonable revised period communicated to you, you may cancel for a full refund. A report delivered later than the expected timeframe in Section 7 does not by itself entitle you to a refund. A delay caused by your failure to provide necessary information, attend a scheduled consultation or return data needed to complete the study does not automatically require a refund, but we will work with you to resolve it.

After report delivery. There is no refund solely because a completed study produces normal findings, does not explain every symptom or has a result you did not expect. Delivery of the report does not remove your right to the included consultation. If the Practice cannot provide that consultation despite your reasonable efforts to arrange it, contact Support for completion of the Service or the refund described above.

Incorrect charges. Direct refunds any amount charged in error. Refunds include taxes collected on the refunded amount, where applicable.

Direct initiates a refund owed under this Section to the original payment method promptly and no later than seven Business Days after your right to the refund is established, or sooner if law requires. If that method cannot receive the refund, we arrange another lawful method with you. We send confirmation, but your bank may take additional time to post the credit. We do not substitute store credit without your agreement. A refund does not cancel a separate, valid Kit Charge, and a Kit Charge dispute does not prevent access to clinical records. Nothing in this Section limits rights or remedies that cannot lawfully be waived.

9. Borrowing and returning the kit

The reusable equipment remains the property of Direct or its supplier. The kit includes the ECG recording device, a configured phone, charging accessories, a case and the other items identified in the packing list. Single-use electrodes and similar supplies should be used and discarded as instructed; you do not have to return used consumables unless the instructions expressly require it. The Service Price is not a purchase price for the reusable equipment.

Take reasonable care of the kit. Use the phone only for the study. Do not alter its settings, install applications, disable security or data transmission, open the device housing, attempt repairs, or allow anyone else to undergo a study with it. Contact Support if an item is missing or damaged when it arrives.

When your study ends or you stop early, return all reusable items by dropping the package at a USPS post office (not a blue collection box) the same day or the next Business Day. If you cancel after the kit is delivered, return it the same way. The seven-Business-Day period in this Section applies in either case. Use the prepaid packaging and USPS label unless Support gives you a different written instruction. Obtain and retain a carrier acceptance receipt or scan when possible. Other reasonable evidence of carrier acceptance may be considered. Another person may drop off the package for you. Contact Support if you need a replacement label, or accessible return assistance.

Kit Charge of $299. Direct will charge $299 (the "Kit Charge") to the card you used at checkout if Direct does not receive the complete kit within seven Business Days after it is delivered to you, if any reusable item is missing, or if the recording device or phone is damaged, including damage found when the manufacturer inspects it. If a late kit is received and passes Direct's inspection, Direct refunds the Kit Charge. The Kit Charge is in addition to the Service Price.

There is no Kit Charge for ordinary wear, used consumables, damaged outer packaging alone, a device defect, or a problem caused by us or our suppliers. If the recording device or phone stops working with no sign of damage, it is returned to the manufacturer for inspection. If the manufacturer finds no damage, it is treated as a device defect and no Kit Charge applies.

If you believe a Kit Charge is incorrect, contact Support. This does not waive your statutory payment-dispute rights.

If the missing kit or item is later received and passes Direct's inspection, Direct refunds the Kit Charge. Credits or recoveries for the same equipment loss are taken into account so that we do not recover twice. Paying a Kit Charge does not transfer ownership; a recovered item should still be returned for the applicable credit.

Return and payment obligations are separate from clinical care. If needed data remains on an unreturned device, the missing data may delay or prevent completion of the report. We will not withhold an existing report, available clinical records, the Practice's access to available data or clinically necessary communication solely because a kit has not been returned or a payment is disputed.

10. Safe use of the kit

Follow the manufacturer instructions supplied with the kit and the Practice's clinical instructions, including instructions for placement, replacement of electrodes, charging, water exposure and removal. Tell the Practice about relevant medical conditions and adhesive allergies during intake. Do not start with damaged equipment or compromised electrode packaging; contact Support for a replacement and the Practice if the issue affects your care.

Adhesive electrodes can cause redness, itching or skin irritation. If your skin becomes painful, blistered or broken, remove the device and contact the Practice promptly. Seek urgent care for a serious reaction. The Practice decides whether you should restart or continue the study. Do not continue simply to avoid a refund or kit-return issue.

Support handles equipment, connectivity, shipping and billing. The Practice handles symptoms, skin reactions and clinical questions. Follow Section 2 for emergencies.

11. Your report and consultation

The recording covers only the period in which the device records usable data. It may miss intermittent events, and a normal result does not rule out every heart condition. Signal quality, interrupted wear, incomplete information and technical problems can limit the findings. Do not change medication or other treatment solely because of a software output or without appropriate clinical advice.

The final report is the Practice physician's clinical interpretation of the available recording. A preliminary technical output is not the signed clinical report. The Practice determines the clinical findings, explains relevant limitations and recommends appropriate next steps. The report is one part of your medical care and should be shared with your usual clinician, especially if symptoms continue or further evaluation is recommended.

The Practice makes your signed report available through a secure channel, with Direct providing administrative delivery support. You may download, keep and share it with clinicians or anyone you choose. The Practice tells you when the report is ready. Direct does not text you about your report, and a notification will not include the report or detailed findings in ordinary text messages. The Practice may contact you directly about a finding requiring attention, as described in Section 2.

The Practice will contact you about arranging the included results consultation. You may access the report without first attending the consultation. Receiving this study does not establish continuing primary or emergency care with Direct, and the Practice's responsibilities for further care are governed by its clinical relationship with you and applicable law.

12. Calls and electronic messages

Provide a telephone number and email address where you can be reached, and tell us promptly if either changes. We and the Practice use appropriate channels for order updates, shipping, appointments, service support and clinical follow-up. The Practice may obtain its own communication consents. Your agreement to these Terms is not consent to marketing messages.

Direct and service providers acting for it send automated texts about your order, kit and study to the number you provide. Message frequency varies with your study. Message and data rates may apply. Reply HELP for help or contact Support. Mobile carriers are not responsible for delayed or undelivered messages. Text updates are required to purchase the Service.

SMS Text Messaging Terms. These SMS terms are part of these Terms. Direct sends text messages only to people who have consented to receive them when ordering. Texts from Direct may come from Direct's organizational phone numbers, including (804) 669-9331. Message and data rates may apply, and message frequency varies. You may text STOP at any time to opt out of receiving text messages from Direct, and text HELP at any time for help. Carriers are not liable for delayed or undelivered messages.

SMS Text Messaging Privacy Policy. We respect your privacy and are committed to protecting your personal information. Any information collected as part of our SMS or text messaging program, including mobile phone numbers, messaging consent, and opt-in data, is used solely for the purpose of providing the messaging services you have opted in to receive. No mobile opt-in data or text messaging consent information will be shared, sold, rented, or disclosed to any third parties, except as required to deliver the messaging service or to comply with applicable laws.

Reply STOP to opt out of Direct's text program, or tell Support through another reasonable method that you want texts or automated calls to stop. We honor revocation promptly within applicable legal deadlines. You may receive one non-promotional confirmation of a text opt-out. Opting out does not cancel the study. We use an alternative communication channel for which we have lawful permission, including manual calls, email or secure messages as appropriate. A revocation delivered to the Practice is handled under its communication procedures; Support can help you reach it.

Marketing texts or automated marketing calls require separate consent when law requires it. Giving marketing consent is never a condition of purchase, and you may withdraw it. We do not treat an order, a clinical consent or acceptance of these Terms as that separate consent.

Ordinary texts and email may not be secure. Do not send sensitive medical information, payment card details, passwords or one-time access codes through those channels. Use the secure clinical channel provided by the Practice for health information. We will not ask you to disclose your password or one-time security code by text.

13. Privacy and use of information

Our Privacy Notice explains how Direct and Inc. handle personal information for their respective roles. The Practice's privacy notice explains its handling of clinical information. Your health intake, recording and clinical report may become part of the record maintained by the Practice. Our handling of information on its behalf is subject to applicable law and the agreements governing that relationship.

We use information as needed to administer your order, verify eligibility and identity, deliver and retrieve the kit, support the study, provide analysis to the Practice, deliver results administratively, handle payments and refunds, maintain security, and meet legal obligations. Authorized personnel and service providers receive access appropriate to their assigned functions. A payment processor or shipping provider does not need your full clinical record simply because it supports the Service.

We maintain administrative, technical and physical safeguards appropriate to the information and our legal obligations. Where we act as a business associate or subcontractor under the Health Insurance Portability and Accountability Act (HIPAA), we comply with the applicable HIPAA obligations and required business associate agreements. Other personal information remains subject to applicable privacy and security law and our Privacy Notice. These Terms do not represent that HIPAA applies to every piece of information on every part of the website.

Authorized support or technical review personnel and service providers may access information from outside the United States, subject to applicable law, appropriate safeguards and contractual restrictions. The Privacy Notice describes relevant processing and sharing. Acceptance of these Terms does not replace any separate consent or authorization required for a particular use or disclosure.

We do not sell your identifiable health information or disclose it to advertisers for their advertising purposes. Where authorized by our agreements with the Practice and permitted by applicable law, we may create and use information de-identified under applicable standards, including HIPAA standards where applicable, for service improvement, product development, analysis and research. We do not attempt to re-identify that information or authorize recipients to do so. Research or other uses of identifiable information requiring separate authorization or another legal basis are not authorized merely by accepting these Terms.

To request access, correction or deletion of information we hold, contact Support using Section 23 or the methods in the Privacy Notice. For your medical record, contact the Practice; we will help route a request. Rights, verification requirements and response periods depend on applicable law. Some records must be retained for clinical, legal, security or quality purposes. Deleting an account does not necessarily delete the clinical record. We explain applicable limitations and do not restrict rights that law gives you.

14. Availability and service changes

AccurBeat has limited capacity and is offered only in approved service areas. We may change availability for future orders, open or close a waitlist, or pause new orders. A shipping expansion does not by itself expand the states in which a physician may treat you.

Changes do not retroactively remove the included services for an accepted order. If we cannot complete an accepted order, Section 8 applies. We coordinate any interruption with the Practice so that available records, identified clinical findings and appropriate follow-up are addressed. Clinical safety, legal requirements and the Practice's independent judgment may require a study to be modified or stopped.

15. Technology content and your report

Direct and their licensors retain their rights in the website, applications, analysis software, report formats, trademarks, logos and other technology and content. Subject to these Terms, you may use the customer-facing features for your own Service and keep copies of these Terms, receipts and your report. Inc. retains its rights in AccurECG 2.0. No right to operate, sublicense or commercially exploit that analysis software is granted to you.

You may not resell the Service, use unauthorized automated tools to access systems, bypass security, copy protected software or content for a competing service, or reverse engineer the technology except to the extent applicable law permits notwithstanding this restriction. This does not prohibit assistive technology, lawful security reporting, ordinary use of your own health information, sharing your report, or exercising a right that cannot be restricted.

Nothing in this Section limits your rights in your own health information or your report. You may keep and share your report, including with another provider, without paying a license fee.

If you voluntarily provide product feedback, you permit us to use the suggestions to improve the Service without compensation. This permission does not transfer ownership of your clinical record, authorize otherwise prohibited use of personal information, restrict an honest review or permit us to identify you publicly without appropriate consent.

16. Appropriate use and suspension

Provide accurate information, protect your account credentials and use the kit only for your own prescribed study. Do not impersonate another person, interfere with systems, upload malicious material, misuse another person's information, or use the Service unlawfully. Notify Support promptly if you suspect unauthorized access.

We may reasonably restrict non-clinical access or cancel an order for a material violation, fraud, security threat or legal requirement. Where practicable, we explain the reason and give you an opportunity to correct a remediable problem. Any refund is governed by Section 8. Restrictions do not authorize us to deny lawful access to existing clinical records or interfere with necessary clinical communication. The Practice independently determines whether and how clinical care should continue or be transitioned.

17. Warranties and clinical limitations

We do not promise that the website, connections or equipment will be uninterrupted or error-free, that every recording will be usable, that a study will detect every event, or that the Service will produce a particular clinical finding or outcome. The express service, repair, replacement and refund commitments in these Terms remain in effect.

To the extent applicable law permits, and except for the express commitments in these Terms, Direct provides its non-clinical services, technology and loaned equipment "as is" and "as available" and disclaims implied warranties, including merchantability and fitness for a particular purpose. This disclaimer does not waive a warranty, duty, product-safety obligation or consumer right that cannot lawfully be waived.

The Practice remains responsible for the clinical services it provides. Neither this Section nor the allocation of roles in Section 1 excuses Direct's own breach, negligence or other conduct for which it is legally responsible.

18. Limits on liability

Subject to the exceptions below and to the extent applicable law permits, neither Direct nor Inc., nor their respective officers, directors, managers, members, employees or contractors acting for them, is liable for indirect, incidental, special, consequential or punitive damages, or lost profits, arising from these Terms or the Service.

Subject to those same exceptions, the total aggregate liability of Direct, Inc. and those persons for claims concerning a particular study will not exceed the greater of $500 and the total amount you paid for that study, including any Kit Charge. This is a combined limit, not a separate limit for each person or claim. Multiple claims concerning the same study do not increase it. For claims that do not concern a purchased study, the limit is $500, subject to the same exceptions.

Neither the exclusions nor the cap applies to death or personal injury; gross negligence, fraud or willful misconduct; a refund, credit or return of an unauthorized charge required by these Terms or law; or any liability, statutory remedy or right that applicable law does not permit us to exclude or limit. They do not reduce the Practice's responsibility for its own clinical services or limit a claim against the Practice.

19. Responsibility for deliberate misuse

You remain responsible for valid payment and return obligations under Sections 5 through 9. Separately, if your fraud, intentional impersonation, knowing falsification of material information or willful misuse of the kit or systems causes a third-party claim against Direct or Inc., you are responsible, to the extent permitted by law, for the direct losses and reasonable costs that Direct proves were caused by that conduct.

This obligation does not apply to an honest mistake, ordinary difficulty using the Service, a good-faith complaint or review, or a claim caused by Direct, Inc., the Practice or their personnel or suppliers. It does not shift their negligence, legal duties or clinical responsibility to you. It creates no obligation for you to assume a defense. Recovery for loss of or damage to the equipment under this or any other provision remains subject to the combined $299 limit and other protections in Section 9, with no double recovery for the same loss. We must notify you promptly of a claim, give you a reasonable opportunity to participate, and obtain your written agreement before a settlement imposes a payment or admission on you. A dispute about this Section is resolved under Section 20.

20. Dispute resolution

Scope and notice of rights. This Section applies to disputes between you and Direct relating to these Terms or the Service, subject to the exclusions below. Inc. may rely on this Section as a third-party beneficiary for any claim you bring against Inc. relating to the Service. For disputes that must be arbitrated, you and Direct give up the right to have a court or jury decide the merits and agree to individual arbitration instead of a class proceeding. An arbitrator's decision is binding, with limited court review. You may opt out as described below.

Informal resolution. Contact Support first if practical. Before starting an arbitration, the party raising a dispute sends written notice describing the facts, the requested resolution and a way to respond. Send notices to Direct's legal address or legal email in Section 23; we send notices to your most recent contact address. The parties will try in good faith to resolve the matter for 60 days after receipt, unless they agree to a shorter period. This process does not prevent a timely small claims filing, a regulatory complaint, a request for urgent court relief or a filing needed to preserve an applicable limitation period or other deadline.

Individual arbitration. Unless you timely opt out or an exclusion applies, a dispute will be decided by one neutral arbitrator administered by the American Arbitration Association (AAA) under its Consumer Arbitration Rules and applicable consumer policies in effect when the case is filed. Rules, filing forms and fee information are available at https://www.adr.org/rules-forms-and-fees/consumer/ or from Support on request. The Federal Arbitration Act governs this arbitration agreement. If these Terms conflict with an applicable mandatory AAA consumer protection, that protection controls. If 25 or more similar arbitration demands are asserted against Direct or Inc. by or with the assistance of the same law firm or coordinated group, the AAA's Mass Arbitration Supplementary Rules will apply.

You may request a documents-only process or a remote hearing where permitted by the AAA rules. Any required in-person hearing will take place in your county of residence or another location you and Direct agree is reasonably convenient. Direct pays the fees that the AAA rules require a business to pay and any additional amount required to make this agreement enforceable. You do not pay more than the consumer share permitted by those rules, and may seek an available fee waiver. This agreement does not impose a general obligation to pay Direct's attorneys' fees if you do not prevail. Statutory fee rights remain available.

The arbitrator may award the individual relief a court could award, including statutory damages, attorneys' fees and individual injunctive relief where authorized by law. The arbitrator must apply applicable law and issue a reasoned written decision. A court may enter judgment on the award. A court, rather than the arbitrator, decides whether an arbitration agreement was formed and disputes about this Section's validity, scope or enforceability, including whether a claim is excluded.

Individual proceedings. To the extent law permits, claims in arbitration proceed only on an individual basis. The arbitrator may not conduct a class, collective or representative proceeding or combine separate customers' claims without all affected parties' agreement. This does not prohibit administrative coordination permitted by applicable AAA rules, or require you to waive relief or a right that cannot lawfully be waived. If a restriction on a particular claim or remedy is unenforceable, that claim or remedy may proceed in court and the remaining arbitrable matters proceed in arbitration. This paragraph does not create a separate class-action waiver for claims that are not subject to arbitration.

Excluded matters and access to courts. Either side may bring an eligible individual claim in a small claims court with proper jurisdiction, including where you reside. Either side may seek temporary court relief needed to protect health or safety, confidential information, data or intellectual property while the appropriate forum decides the dispute. You may contact a regulator, seek a statutory medical-bill dispute process or request public injunctive relief in court where law makes that right nonwaivable. The Practice and its clinicians are not parties to this arbitration agreement. Claims against them, and medical malpractice or other claims arising from the provision of or failure to provide clinical care, are not required to be arbitrated under these Terms.

This agreement is subject to the AAA's healthcare policies. If the AAA determines that a dispute cannot be administered under those policies, or declines administration because of Direct's failure to comply with the applicable rules or payment requirements, you may bring the dispute in court. If the AAA is otherwise unavailable, the parties may agree to another administrator after the dispute arises; without that agreement, either may proceed in court. These Terms do not compel use of a substitute administrator to avoid an applicable AAA consumer or healthcare protection.

Your 30-day right to opt out. You may reject the arbitration agreement by emailing complaints@accurbeat.com or mailing a notice to the legal address in Section 23 within 30 days after you first accept these Terms. Include your name, the email address associated with your order and a clear statement that you opt out of arbitration. An email sent or letter postmarked within that period is timely. One notice is effective for later orders under this arbitration agreement and for any claim against Inc. Opting out does not affect the price, eligibility or Service. If you opt out, neither side can require arbitration under these Terms, and these Terms do not impose a separate class-action waiver on you.

Governing law and court proceedings. New York law governs these Terms, except that the Federal Arbitration Act governs arbitration and any mandatory protections of the state where you reside remain available. A dispute permitted to proceed in court may be brought in the state courts in New York County, New York, or the United States District Court for the Southern District of New York, if it has jurisdiction. You may also use a court in your state of residence where mandatory law or applicable AAA consumer protections entitle you to do so. The small claims exception above remains available. To the extent permitted by applicable law, for any dispute that proceeds in court (other than small claims court), both you and Direct (and Inc.) knowingly and voluntarily waive any right to a trial by jury.

Time limit to bring claims. To the extent permitted by applicable law, any claim or dispute arising out of or relating to these Terms or the Service (other than claims for death or personal injury) must be commenced within one (1) year after the cause of action accrues; otherwise, such claim is permanently barred.

21. Changes to these Terms

The version presented when you place an order applies to that order. We may update the Terms for future orders by posting the revised version with a new date and presenting it for acceptance at checkout. Posting a change does not retroactively change an accepted order or an existing dispute. An arbitration opt-out remains effective as stated in Section 20. We retain the order version and can provide it on request.

22. General provisions

Electronic records and signatures. You may accept these Terms electronically. You can download or print them, and we provide an electronic confirmation of your order. Where the law requires a disclosure to be in writing and permits electronic delivery with consent, any required electronic-delivery consent and access disclosures are provided separately. An ordinary order acceptance does not override those requirements. You may request a paper copy of these Terms without charge or update your contact details through Support. Withdrawal of a separate electronic-delivery consent is handled under that consent and applicable law; it does not erase completed transactions or accrued rights.

Agreement documents. These Terms, the price and included services disclosed for your order, and the factual statements and payment authorizations you affirm at checkout form the agreement for the Service with Direct. The refund policy is Section 8. Our Privacy Notice explains data practices and does not expand the clinical services or replace a legally required authorization. The Practice's clinical agreements remain separate.

Assignment. Direct may transfer its rights and obligations to an affiliate or a successor to the relevant business that assumes those obligations. A transfer does not reduce your rights for an accepted order, release liability already incurred or permit use of your information contrary to applicable law and privacy commitments. You may not transfer the study to another person because the clinical order is specific to you.

Severability and waiver. Except as Section 20 specifically provides, if a provision is unenforceable, it applies only to the extent lawful and the remaining Terms continue. Failure to enforce a provision on one occasion is not a waiver of later enforcement.

Language and accessibility. If a translation is provided, the English version controls to the extent law permits and except where we expressly agree otherwise. This does not limit required language access or accessibility assistance. Contact Support for an accessible format or assistance. We do not discriminate on a basis prohibited by law. The Service remains subject to the age, clinical, geographic and other eligibility requirements in these Terms.

Third-party beneficiaries. AccurKardia, Inc. is an express third-party beneficiary of all disclaimers, limitations, rights, and protections afforded to Direct under these Terms. Except as expressly stated for Inc., there are no third-party beneficiaries to these Terms.

Events outside our control. Direct is not liable for a delay or failure to perform non-clinical obligations caused by events beyond its reasonable control, including postal or carrier disruptions, telecommunications or internet outages, severe weather, or governmental actions, provided that your cancellation and refund rights under Section 8 remain in full effect if we cannot complete your Service within a reasonable time.

Continuing provisions. Accrued payment, refund and kit-return obligations, lawful record and privacy obligations, intellectual property provisions, applicable liability provisions and dispute-resolution provisions continue after the study ends to the extent needed to give them effect. Ending an account or a Service does not end rights to clinical records or required follow-up.

23. Contact information

Clinical questions and results: Contact the Practice through Spruce, the Practice's secure messaging app (the Practice sets you up during registration), Monday through Friday, 8:00 a.m. to 6:00 p.m. Eastern Time. The Practice provides its routine availability and instructions for clinical follow-up. Support can help connect you. Do not use routine messages for an emergency.

Orders, equipment, shipping, billing and accessibility: Contact AccurBeat Support by text or telephone at (804) 669-9331 or email support@accurbeat.com, Monday through Friday, 9:00 a.m. to 5:00 p.m. Eastern Time, excluding U.S. federal holidays. After-hours non-emergency requests are handled the next Business Day.

Legal notices to Direct: AccurKardia Direct, LLC, Attention: Legal, 101 Avenue of the Americas, Suite 931, New York, New York 10013, or by email to complaints@accurbeat.com.

Emergencies: Call 911 or seek care at the nearest emergency department.