Participant acknowledges and agrees that by using the services offered by Envision Medical Solutions, affiliates and partners, certain information related to the prescriptions obtained through the program will be collected. Some of this information may be associated with Participant and may constitute protected health information (PHI) under HIPAA. Participant acknowledges and agrees that this information will be used for the administration of the program and any affiliate programs. Any PHI collected by Envision Medical Solutions, affiliates and partners, shall be maintained as confidential, protected in accordance with HIPAA, and not be disclosed except as authorized by Participant. If you choose to opt out of affiliate and partner information sharing, you must contact Envision Medical Solutions in writing at: 3710 Corporex Park Drive, Suite 215, Tampa, FL 33619.