Terms of service

Effective Date: 11/05/2023
Last Updated: 11/13/2026

1. Introduction and Acceptance

These Terms of Service (“Terms”) constitute a legally binding agreement between you (“Customer,” “you,” or “your”) and Pruett & Co., LLC, DBA AlpineForm (“AlpineForm,” “we,” “us,” or “our”) governing your access to and use of the AlpineForm website, platform, and services (collectively, the “Services”).

By accessing or using our Services, creating an account, or clicking to accept these Terms, you agree to be bound by these Terms. If you are entering into these Terms on behalf of an organization, you represent that you have the authority to bind that organization.

If you do not agree to these Terms, do not access or use our Services.

These Terms incorporate by reference our Privacy Policy and, for customers who handle protected health information, our Business Associate Agreement (“BAA”).

2. Description of Services

AlpineForm provides HIPAA-compliant electronic web-based form services for healthcare providers. Our Services include:

• Form Creation: Development of customized electronic web-based forms that collect patient information
• Form Hosting: Secure hosting of electronic forms accessible via web browser
• Form Processing: Processing of submitted form data
• PDF Generation: Conversion of submitted data into completed PDF versions of provider forms
• Secure Delivery: Email delivery of completed forms to healthcare providers via encrypted transmission
• Data Storage: Secure storage of form submissions in compliance with HIPAA requirements

Our Services are designed to improve the patient paperwork experience and provide an accessible, user-friendly alternative to traditional pen-and-paper forms.

3. Eligibility and Registration

3.1 Eligibility

Our Services are intended for healthcare providers and organizations that are covered entities or business associates under HIPAA. By using our Services, you represent that:

• You are at least 18 years old
• You have the legal authority to enter into these Terms
• You are a healthcare provider or authorized representative of a healthcare organization
• Your use of the Services will comply with all applicable laws and regulations

3.2 Account Registration

To use our Services, you must create an account. You agree to:

• Provide accurate, current, and complete registration information
• Maintain and promptly update your account information
• Keep your login credentials secure and confidential
• Not share your account credentials with unauthorized persons
• Notify us immediately of any unauthorized access to your account
• Accept responsibility for all activities that occur under your account

4. Business Associate Agreement

4.1 HIPAA Compliance Requirement

If you will use our Services to collect, process, store, or transmit protected health information (PHI), you must execute a Business Associate Agreement with AlpineForm before uploading or transmitting any PHI through our platform.

4.2 BAA Incorporation

For customers who execute a BAA, the terms of that agreement are incorporated into and form part of these Terms. In the event of any conflict between these Terms and the BAA regarding the handling of PHI, the BAA shall control.

4.3 Customer HIPAA Obligations

You are responsible for your own HIPAA compliance, including but not limited to:

• Implementing appropriate administrative, physical, and technical safeguards
• Training your workforce on HIPAA requirements
• Obtaining any required patient authorizations or consents
• Complying with HIPAA Privacy Rule requirements
• Maintaining your own policies and procedures

5. Fees and Payment

5.1 Subscription Fees

Our Services are provided on a monthly subscription basis. Current pricing is available on our website or upon request.

5.2 Free Trial

We offer a thirty (30) day free trial for new customers. The trial begins on the day your first form goes live, not when you sign up. During the trial period, you may access and evaluate our Services at no charge, and no payment details are required. At the end of the trial period, you must subscribe to continue using the Services.

5.3 Payment Terms

• Subscription fees are billed in advance each month
• We accept the payment methods offered when you subscribe
• All payments are processed by our third-party payment processor
• Fees are non-refundable except as expressly stated in these Terms

5.4 Payment Failure

If payment fails or is not received, we will attempt to contact you to resolve the issue. If payment is not received within thirty (30) days, we reserve the right to deactivate your forms until payment is received.

5.5 Refunds

We offer a full refund within thirty (30) days of your first subscription payment if you are not satisfied with our Services. This 30-day refund period applies only to the first subscription payment and does not apply to renewal payments. After the initial 30-day period, refunds are considered on a case-by-case basis at our discretion.

5.6 Price Changes

We may change our subscription fees upon thirty (30) days’ notice. Price changes will take effect at the start of your next billing cycle following the notice period.

6. Customer Responsibilities

6.1 Acceptable Use

You agree to use our Services only for lawful purposes and in accordance with these Terms. You are responsible for:

• Maintaining accurate account information
• Keeping login credentials secure
• Ensuring your use complies with all applicable laws, including HIPAA
• Obtaining appropriate consents from patients for electronic form submission
• Reviewing completed forms for accuracy
• Maintaining your own records as required by law

6.2 Prohibited Uses

You agree not to:

• Use the Services for any unlawful purpose
• Violate any applicable laws or regulations
• Transmit any malicious code, viruses, or harmful content
• Attempt to gain unauthorized access to our systems
• Interfere with or disrupt the Services
• Resell or redistribute the Services without authorization
• Use the Services in any manner that could damage or overburden our systems
• Collect or harvest information about other users

6.3 Content Restrictions

We reserve the right to decline service or terminate accounts at our discretion and without obligation to provide a reason.

7. Intellectual Property

7.1 AlpineForm Ownership

AlpineForm owns all rights, title, and interest in and to:

• The AlpineForm platform, software, and technology
• Our website design, logos, and trademarks
• The web-based electronic forms created using our platform
• All improvements and modifications to our Services

7.2 Customer Ownership

You retain ownership of:

• Your original PDF forms and templates that you provide to us
• The content and data submitted through forms (subject to our rights to process such data to provide the Services)
• Your trademarks and branding elements

7.3 Data Submitted Through Forms

Data submitted through forms belongs to you (the covered entity customer). We process this data solely to provide the Services and as permitted by our Business Associate Agreement. We do not use customer data or patient data to improve our services or for any purpose other than providing the contracted Services.

7.4 License Grant

You grant AlpineForm a limited, non-exclusive license to use your PDF forms, trademarks, and branding elements solely as necessary to provide the Services.

8. Disclaimer of Warranties

THE SERVICES ARE PROVIDED “AS IS” AND “AS AVAILABLE” WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, AND NON-INFRINGEMENT.

WE DO NOT WARRANT THAT:

• THE SERVICES WILL BE UNINTERRUPTED OR ERROR-FREE
• DEFECTS WILL BE CORRECTED
• THE SERVICES ARE FREE OF VIRUSES OR HARMFUL COMPONENTS
• THE RESULTS OF USING THE SERVICES WILL MEET YOUR REQUIREMENTS

SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF IMPLIED WARRANTIES, SO SOME OF THE ABOVE EXCLUSIONS MAY NOT APPLY TO YOU.

9. Limitation of Liability

9.1 Limitation of Damages

TO THE MAXIMUM EXTENT PERMITTED BY LAW, IN NO EVENT SHALL ALPINEFORM, ITS OFFICERS, DIRECTORS, EMPLOYEES, OR AGENTS BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO LOSS OF PROFITS, DATA, USE, OR GOODWILL, ARISING OUT OF OR RELATED TO YOUR USE OF THE SERVICES.

9.2 Cap on Liability

OUR TOTAL LIABILITY FOR ALL CLAIMS ARISING OUT OF OR RELATED TO THESE TERMS OR THE SERVICES SHALL NOT EXCEED THE TOTAL FEES PAID BY YOU TO ALPINEFORM DURING THE TWELVE (12) MONTHS IMMEDIATELY PRECEDING THE EVENT GIVING RISE TO THE CLAIM.

9.3 BAA Provisions

Additional limitations of liability specific to the handling of protected health information may be set forth in your Business Associate Agreement.

9.4 Essential Purpose

THE LIMITATIONS IN THIS SECTION APPLY EVEN IF ANY LIMITED REMEDY FAILS OF ITS ESSENTIAL PURPOSE.

10. Indemnification

You agree to indemnify, defend, and hold harmless AlpineForm and its officers, directors, employees, and agents from and against any claims, liabilities, damages, losses, costs, and expenses (including reasonable attorneys’ fees) arising out of or related to:

• Your use of the Services
• Your violation of these Terms
• Your violation of any applicable law or regulation
• Your violation of any third-party rights
• Any data or content you submit through the Services
• Any claim by a patient or third party related to your use of the Services

Additional indemnification provisions may be set forth in your Business Associate Agreement.

11. Term and Termination

11.1 Term

These Terms are effective upon your acceptance and continue until terminated.

11.2 Customer Termination

You may terminate your subscription at any time by providing thirty (30) days’ written notice. Upon termination:

• You remain responsible for any fees incurred through the termination date
• Your access to the Services will end at the conclusion of your current billing period or notice period, whichever is later

11.3 AlpineForm Termination

We may terminate or suspend your access to the Services:

• Immediately, without notice, for:
  • Breach of these Terms
  • Breach of the Business Associate Agreement
  • Non-payment that remains unresolved for thirty (30) days
  • Illegal activity
  • Conduct that we determine, in our sole discretion, poses a risk to our Services or other users
• With thirty (30) days’ notice, for any other reason

11.4 Effect of Termination

Upon termination:

• Your right to access and use the Services ceases at the end of your notice period or billing period, as applicable
• Within thirty (30) days of termination, we will return to you (or, if agreed upon, destroy) all protected health information we maintain on your behalf
• We will permanently delete all protected health information from our live systems within thirty (30) days of termination, except for information we are required to retain by law. Copies held in our encrypted backups are handled as described in our Business Associate Agreement
• Upon request, we will provide written certification of deletion
• We may retain protected health information only as necessary for our proper management and administration or to carry out our legal responsibilities, as permitted by law
• Provisions that by their nature should survive termination will survive, including ownership, warranty disclaimers, indemnification, and limitations of liability

12. Dispute Resolution

12.1 Informal Resolution

Before initiating any formal dispute resolution, you agree to first contact us and attempt to resolve the dispute informally. Most concerns can be resolved quickly through direct communication.

12.2 Binding Arbitration

Any dispute, claim, or controversy arising out of or relating to these Terms or the Services that cannot be resolved informally shall be resolved by binding arbitration in accordance with the rules of the American Arbitration Association. The arbitration shall take place in Rockingham County, Virginia.

12.3 Class Action Waiver

YOU AND ALPINEFORM AGREE THAT EACH PARTY MAY BRING CLAIMS AGAINST THE OTHER ONLY IN YOUR OR ITS INDIVIDUAL CAPACITY AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING. Unless both you and AlpineForm agree otherwise, the arbitrator may not consolidate more than one person’s claims and may not otherwise preside over any form of a representative or class proceeding.

12.4 Exceptions

Notwithstanding the above, either party may seek injunctive or other equitable relief in any court of competent jurisdiction to prevent the actual or threatened infringement of intellectual property rights.

12.5 Governing Law

These Terms shall be governed by and construed in accordance with the laws of the Commonwealth of Virginia, without regard to its conflict of law provisions.

12.6 Jurisdiction

For any matters not subject to arbitration, you consent to the exclusive jurisdiction of the state and federal courts located in Rockingham County, Virginia.

12.7 Waiver of Jury Trial

EACH PARTY HEREBY IRREVOCABLY WAIVES ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY LEGAL PROCEEDING ARISING OUT OF OR RELATED TO THESE TERMS OR THE SERVICES.

13. General Provisions

13.1 Entire Agreement

These Terms, together with the Privacy Policy, Business Associate Agreement (if applicable), and any other agreements expressly incorporated by reference, constitute the entire agreement between you and AlpineForm regarding the Services.

13.2 Modifications

We may modify these Terms at any time. We will provide notice of material changes by:

• Posting the updated Terms on our website
• Sending email notice to the address associated with your account
• Providing at least thirty (30) days’ notice before material changes take effect

Your continued use of the Services after the effective date of any modifications constitutes acceptance of the modified Terms.

13.3 Waiver

Our failure to enforce any provision of these Terms shall not constitute a waiver of that provision or any other provision.

13.4 Severability

If any provision of these Terms is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect.

13.5 Assignment

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

13.6 Notices

Notices to AlpineForm should be sent to:

Pruett & Co., LLC, DBA AlpineForm
Attention: Scott Pruett
Email: scott@alpineform.com
Phone: (540) 358-0137

Notices to you will be sent to the email address associated with your account.

13.7 Force Majeure

Neither party shall be liable for any failure or delay in performance due to causes beyond its reasonable control, including but not limited to acts of God, natural disasters, war, terrorism, riots, embargoes, acts of civil or military authorities, fire, floods, accidents, strikes, or shortages of transportation, facilities, fuel, energy, labor, or materials.

14. Contact Information

If you have questions about these Terms of Service, please contact us:

Pruett & Co., LLC, DBA AlpineForm

Contact: Scott Pruett, Founder
Email: scott@alpineform.com
Phone: (540) 358-0137
Address:
Pruett & Co., LLC
8401 Mayland Dr, Suite A
Richmond, VA 23294 USA

By using AlpineForm Services, you acknowledge that you have read, understood, and agree to be bound by these Terms of Service.