HIPAA Marketing Authorization Consent

Overtime Health LLC

HIPAA Marketing Authorization Consent Effective date: November 13, 2026

BY CLICKING “I AGREE,” CHECKING A RELATED BOX TO SIGNIFY YOUR ACCEPTANCE, USING ANY OTHER ACCEPTANCE PROTOCOL PRESENTED THROUGH THE SERVICE, OR OTHERWISE AFFIRMATIVELY ACCEPTING THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE READ, ACCEPTED, AND AGREED TO BE BOUND BY THIS CONSENT. IF YOU DO NOT AGREE TO THIS CONSENT, DO NOT CREATE AN ACCOUNT OR USE THE SERVICE. YOU HEREBY GRANT AGENCY AUTHORITY TO ANY PARTY WHO CLICKS ON THE “I AGREE” BUTTON OR OTHERWISE INDICATES ACCEPTANCE TO THIS CONSENT ON YOUR BEHALF.

Authorization

I authorize Overtime Health LLC (“Overtime”) and its marketing and advertising vendors, agents, and contractors to use and disclose my protected health information as described below for marketing purposes.

Description of Information to Be Used or Disclosed

The protected health information that may be used or disclosed includes:

• My name, telephone number, email address, and other contact information
• Information I submit through online or written inquiry, appointment, or consultation request forms
• General information regarding my medical condition, symptoms, or treatment interests as submitted by me, whether through telehealth or otherwise

Purpose of Use or Disclosure

The purpose of this use or disclosure is:

• To contact me regarding medical services offered by Overtime
• To schedule appointments or consultations
• To fulfill prescriptions through Overtime’s pharmacy partners
• To provide information about medical services, promotions, or offerings of the Practice

Persons Authorized to Disclose

The following persons or entities are authorized to disclose my protected health information:

• Overtime;
• Its employees, contractors, and marketing or advertising service providers; and
• Its pharmacies, medical groups, or providers

Persons Authorized to Receive

The following persons or entities are authorized to receive my protected health information:

• Overtime;
• Marketing, advertising, lead generation, or appointment scheduling service providers acting on behalf of Overtime; and
• Pharmacies, medical groups, or providers acting on behalf of Overtime.

Financial Remuneration Disclosure

I understand that Overtime or its marketing vendors may receive financial remuneration in connection with marketing communications or lead generation activities related to my inquiry or appointment request.

Expiration

This authorization will expire one year from the date of my signature unless revoked earlier in writing.

Right to Revoke

I understand that I may revoke this authorization at any time by submitting a written request to:

Overtime Health LLC
30 N Gould St Ste #55815
Sheridan, WY 82801
support@startovertime.com

Revocation will not affect any use or disclosure already made in reliance on this authorization.

Redisclosure Notice

I understand that information disclosed pursuant to this authorization may be subject to redisclosure by the recipient and may no longer be protected by federal HIPAA privacy regulations.

Authorization

I understand that agreeing to this authorization is required for the performance of Services.