Website Terms of Use

The Perinatal Quality Foundation, which includes the Nuchal Translucency Quality Review Program ("NTQR"), the Credentialing Examination for Fetal Heart Monitoring ("FMC"), the Cervical Length Education and Review ("CLEAR") program and the Genetic Education Modules ("GEM") (generally referred to as the "Foundation", "we," "us", or "our"), provides and makes available the Foundation's website:

• http://www.perinatalquality.org

(which we refer to as the "Website").

In additional, we make available the following special topic websites:

• http://clear.perinatalquality.org
• http://fmc.perinatalquality.org
• http://gem.perinatalquality.org
• http://ntqr.perinatalquality.org

(which we call all together the "Topic Websites," and which we call each a "Topic Website". We may also call each Topic Website individually as the "NTQR Website", the "CLEAR Website", the "FMC Website" or the "GEM Website").

Your use of the Website and each Topic Website is subject to the terms and conditions contained in these Terms of Use together with the Terms of Use for a specific Topic Website. (the "Agreement"). For example, if you register to use the GEM Website, you will have to agree to the Terms of Use for the Website as well as the specific Terms of Use for the GEM Website. Please read this Agreement carefully. By accessing, browsing or otherwise using the Website or any Topic Website, you acknowledge that you have read, understood, and agree to be bound by this Agreement. If you do not accept the terms and conditions of this Agreement, you should not access, browse or use the Website. Each of the Topic Websites may have additional Terms of Use specific to that website and which you must acknowledge and accept before accessing that Topic Website. If you do not accept the Terms of Use of a Topic Website, you will not be able to access it. Be sure you read and understand the Terms of Use for each Topic Website you access and the nature of the information provided on the Topic Website before using the Topic Website or providing personal information to it.

1.2 You understand and agree that we may change this Agreement at any time without prior notice. If you maintain an active account with us, you will have to provide us with an active and valid email account that you use, and we will provide you an email notice of any change(s) to the Agreement. You may read a current copy of the Agreement covering this Website at any time by selecting the "Terms of Use" link on the Website (http://www.perinatalquality.org/wfPrivacy.aspx). You may review the Terms of Use of a Topic Website by visiting the website for that topic and by selecting the Terms of Use for that Topic Website. Any revised terms and conditions will become effective immediately upon posting, unless we state otherwise in any revised Terms of Use. If you use the Website or a Topic Website after we post a change to the Terms of Use to the Website of the applicable Topic Website, we will assume your use means you accept all of the revised terms and conditions. If you do not agree to any change to this Agreement, your only remedy is to stop accessing, browsing and using the Website or Topic Website.

1.3 Your access to and use of this Website and any Topic Website are also subject to Privacy Policies that we use to help ensure your privacy. You may review our Privacy Policies by following the link on our home page. One or more of the Topic Websites may allow you to upload your personal health care information to that Topic Website or to use the Topic Website to exchange your personal health information with your physician. That personal health care information may constitute protected health information ("PHI"), as defined under the Health Insurance Portability and Accountability Act ("HIPAA") regulations. 42 CFR Parts 160 and 164. For any Topic Website which lets us receive, store and transmit PHI, we will establish and maintain physical, administrative and technical security standards to comply with HIPAA regulations as a business associates of a physicians who access patients PHI through a Topic Website. Not all uses of the Foundation require compliance with HIPAA. When we must, we will post Privacy Policies and other information demonstrating our HIPAA compliance. In addition, some of the information you may provide may be considered genetic information as defined under the Genetic Information Nondiscrimination Act of 2008 ("GINA"), H.R. 493. Our compliance with the requirements of GINA are made through our HIPAA compliance efforts. We will consider any genetic information you provide to be PHI.

2.1 The Website and the Topic Websites contain material, including but not limited to software, text, graphics, images, videos and interactive materials (collectively referred to as the "Content"). For the avoidance of doubt, PHI is never considered to be our "Content." We own the Content, or portions of the Content may be made available to us through arrangements that we have with third-parties. Regardless of whether the Content is owned by us or others, the Content is protected by United States and international copyright and other intellectual property laws. Unauthorized use of the Content may violate copyright, trademark, and other laws. You have no rights in or to the Content, and you will not use, copy or display the Content except as permitted under this Agreement. No other use is permitted without our prior written consent. You must retain all copyright and other proprietary notices contained in the original Content on any copy you make of the Content. (In other words, if you print some of the Content for your own use, you must include on the printed copy any copyright notice which we or anyone else put there.) You may not sell, transfer, assign, license, sublicense, or modify the Content or reproduce, display, publicly perform, make a derivative version of, distribute, or otherwise use the Content in any way for any public or commercial purpose. The use or posting of any of the Content on any other website or in a networked computer environment for any purpose is expressly prohibited. If you violate any part of this Agreement, your right to access and/or use the Content and Website shall automatically terminate and you must immediately destroy any copies you have made of the Content.

2.2 The trademarks, service marks, and logos of the Foundation and its programs (the "Foundation Trademarks") used and displayed on the Website and Topic Websites are registered and unregistered trademarks or service marks of the Foundation. Other company product and service names located on the Website may be trademarks or service marks owned by third-parties (the "Third-Party Trademarks", and, collectively with the Foundation Trademarks, the "Trademarks"). Nothing on this Website, in any Topic Website or in this Agreement should be construed as granting, expressly, by implication, estoppel, or otherwise, any license or right to use any Trademark displayed on the Website or any Topic Website without the prior written consent of the Foundation specific for each such use. The Trademarks may not be used to disparage the Foundation or any applicable third-party, the Foundation's or any third-party's products or services, or in any manner that may damage any goodwill in the Trademarks. All goodwill generated from the use of any Foundation Trademark shall inure to the Foundation's benefit.

2.3 You agree not to: (a) take any action that imposes an unreasonable load on the Website's or any Topic Website's infrastructure, (b) use any device, software or routine to interfere or attempt to interfere with the proper working of the Website or any Topic Website or any activity being conducted on the Website or any Topic Website, (c) attempt to decipher, decompile, disassemble or reverse engineer any of the software comprising or making up the Website or any Topic Website, (d) delete or alter any material posted on the Website or Topic Website by the Foundation or any other person or entity, (e) frame or link to any of the materials or information available on the Website or Topic Website, or (f) access, attempt to access, review, attempt to review, use, receive, transmit, store or copy any PHI in our possession through the Website or any Topic Website in any manner prohibited by HIPAA or our HIPAA policies.

2.4 The Website or a Topic Website may contain links to third-party websites ("External Sites"). We provide these links solely as a convenience to you and not as an endorsement by us of the content on those External Sites. The content on any External Site is developed and provided by others. You should contact the site administrator or Webmaster for an External Site you browse if you have any concerns regarding its links or any content located on the External Site.

We are not responsible for the content of any linked External Site and do not make any representations regarding the content or accuracy of any materials on such External Site. You should take precautions when downloading files from websites to protect your computer from viruses and other destructive programs. If you decide to access any External Sites, you do so at your own risk. You should review the Terms of Use and Privacy Policies of each External Site you choose to visit. External Sites may have Terms of Use and Privacy Policies very different from ours.

2.5 Certain elements of the Website and Topic Websites are protected by trade dress, trademark, copyright, and other state and federal laws and may not be copied or imitated in whole or in part, by any means, including, but not limited to, the use of framing or mirrors, except as otherwise expressly permitted by Section 2.1 of the Agreement. None of the Content for the Website or any Topic Website may be retransmitted without the express written consent from the Foundation for each and every instance.

2.6 The Digital Millennium Copyright Act of 1998 (the "DMCA") provides recourse for copyright owners who believe that material appearing on the Internet infringes their rights under U.S. copyright law. If you believe in good faith that materials on the Website or any Topic Website infringe your copyright, you (or your agent) may send us a notice requesting that the material be removed or access to it blocked. Notices and counter-notices must meet the then current statutory requirements imposed by the DMCA. Notices and counter notices with respect to the Website should be sent to the Foundation:

By Mail:
Jean Lea Spitz, Executive Director
Perinatal Quality Foundation
P.O. Box 21803
Oklahoma City, OK 73156
By Email : jspitz@perinatalquality.org

2.7 If you are a patient or a health care provider, you may, through one or more the Topic Websites, submit PHI, including genetic information, about you or your patients. For clarity, one or more of our Topic Websites may permit physicians and patients to provide PHI about a patient in furtherance of an established doctor-patient relationship. We do not own any PHI you submit. The ability for you to submit PHI is highly restricted. You should not attempt to provide any PHI in any way which is not strictly in compliance with terms and conditions we impose for submission. Prior to accepting any submitted PHI, we will implement policies and procedures implementing HIPAA security and privacy standards ("HIPAA Policies") for submitted PHI. We will not accept, and will return or destroy, any PHI which is not submitted in compliance with our HIPAA Policies. We will provide and maintain suitable physical, technical and administrative security for submitted PHI and we will comply with HIPAA privacy requirements for all PHI. We acknowledge that some PHI which might be submitted to us may include personal genetic information for which the Genetic Information Nondisclosure Act ("GINA") applies. Neither these Terms of Use nor the Terms of Use for a Topic Website fully describe our HIPAA Policies or our compliance with GINA. To review our HIPAA and GINA policies, please go to our HIPAA page.

3.1 The Content may include the ability to perform different types of assessments through software in the Website or a Topic Website. Software programs are designed and intended to operate based on information from you in order to perform the requested assessment based on information provided by you. ("Assessments"). Professional Assessments ("Professional Assessments") may involve providing specialized training to health care professionals who then, in a testing environment, provide information to a Topic Website to determine the health care professional's understanding of the training materials. Assessments may also include health care Assessments ("Health Care Assessments") for patients to help them determine and understand certain health risks. Patients provide information to the Topic Website in order for the Topic Website software to perform a calculation of the patient's possible risk of a health concern. Health information elicited may include PHI. Please be aware that some information you provide, including some personal health information, may not be PHI as defined by HIPAA regulations and may not be subject to the HIPAA Privacy Rule. Results are provided to the patient and the patient's physician.

3.2 If you are a health care provider,, you agree that the Professional Assessments contain confidential information of the Foundation, and that your access to and use of the Professional Assessments is pursuant to a limited, terminable, revocable license from the Foundation solely for the purpose of responding to the Professional Assessments in connection with your use of the applicable Website or Topic Website under this Agreement. You represent, warrant, and covenant that you will not copy, distribute, or in any way disseminate any or all of the questions or topic areas comprising the Professional Assessments. For any or each Professional Assessment, you further represent, warrant, and covenant that you will complete the Professional Assessment solely utilizing your unaided memory, and that you will not consult any third parties or external materials in responding to the Professional Assessment questions.

3.3 If you are an individual, you acknowledge and agree that health information you provide to a Health Care Assessment must be personal to you and accurate to the best of your knowledge. For any Health Care Assessment, you must agree to provide your information and the Health Care Assessment results to your health care provider. We will enter into a HIPAA-compliance business associate agreement with your physician prior to providing your physician with access to your PHI.

3.4 You acknowledge and agree that your entry into and use of any Topic Website may be conditioned on your acceptance of and agreement to additional terms and conditions of use specific to that Topic Website.

3.5 In consideration for your use of the Website and Topic Website for a Professional Assessment, you hereby assign and transfer, or, to the extent any such assignment or transfer cannot be made at the present time, agree to assign and transfer to the Foundation your right, title and interest to the information that you provide in response to the Professional Assessments. You understand and agree as to any Health Care Assessments, your PHI may be subject to HIPAA regulations and that we will comply with those regulations. To the extent any information provided by you is not covered by HIPAA regulations, we will not use any such information except in conformance with posted Terms of Use and our Privacy Policy, to which you have agreed. We do not and will not own any of your PHI and will not attempt to assert any ownership interest over the data within it unless the PHI has been properly de-identified in accordance with our HIPAA Policies.

4.1 The Perinatal Quality Foundation is not a provider of medical services. We do not diagnose or treat any medical condition, disease, illness or disability. There is no patient-practitioner relationship between you and us. We provide information and Assessment tools based on current accepted medical research and which may be used by you and/or your health care provider to raise awareness, provide unbiased information and to help identify and understand pregnancy risks. All Health Care Assessment tools rely on statistical models and not directly on any form of direct genetic testing on you. Your use of this Website is solely for the purpose of accessing the information and Health Care Assessment tools we provide and is conditioned on your understanding of the benefits and limitations of the information provided in these Health Care Assessment tools. You are responsible for reading and understanding any informational material or support materials about each Health Care Assessment tool you use on this Website. All information on this Website is used at your own risk. Health Care Assessment tools provided on this website should be used only in conjunction with a valid patient-provider relationship and subject to all limitations identified on the Website regarding the diagnostic tool. Please do not use any Health Care Assessment Tool provided by this Website outside of a discussion with your health care provider involving all of the facts and information available about your pregnancy and the Health Care Assessment tools on this Website. .

4.2 Perinatal Quality Foundation represents and warrants that it owns or has sufficient legal rights in the Content and will defend, indemnify, and hold harmless any authorized user of the Content against any claims alleging misappropriation or infringement of third party intellectual property rights arising from the user's authorized use of the Content.

4.3 Except as otherwise set forth in article 5, the Perinatal Quality Foundation, its affiliates, their respective officers, directors, employees, agents, suppliers, licensors, and the authors and their affiliates, officers, directors, employees, agents, suppliers, licensors and sponsoring organizations (collectively, the "Foundation Parties") make no warranties or representations about the Content, including but not limited to its accuracy, completeness, timeliness, or reliability. The Foundation Parties are not liable for the truth, accuracy or completeness of the Content or any other information conveyed to the user or for errors, mistakes or omissions therein or for any delays or interruptions of the data or information stream from whatever cause. You agree that your use the Website, any Topic Website and the content is at your own risk.

The Foundation Parties do not warrant that the Website will operate error free or that the Website or Topic Website, its server, or the Content is free of computer viruses or similar contamination or destructive features. If your use of the Website, a Topic Website or the Content results in the need for servicing or replacing equipment or data, no Foundation Party shall be responsible for those costs.

Except as otherwise set forth in article 5, the Website, Topic Website and Content are provided on an "as is" and "as available" basis without any warranties of any kind. The Foundation Parties disclaim all warranties, including, but not limited to, the warranties of title, merchantability, non-infringement of third parties rights, and fitness for particular purpose.

4.4 Prior to using any of any Assessment tool provided through this Website (Health Care or Provider), we strongly urge you to (i) read and understand all information provided on any Assessment tool you want to use, (ii) if you are a physician, understand the proper uses of each Assessment tool and any improper uses, (iii) if you are a patient, speak with your health care provider about the uses and limitations of these or any Assessment tools and (iv) obtain follow up information as indicated relative to any information provided by any Assessment tool. NOT USE ANY ASSESSMENT TOOL PROVIDED ON THIS WEBSITE AS THE SOLE OR PRIMARY BASIS FOR A DIAGNOSIS OR THE UNDERTAKING OF ANY TREATMENT.

4.5 In no event shall any Foundation Party be liable to any Content user, Content beneficiary, or any third party for any damages whatsoever (including, without limitation, incidental and consequential damages, lost profits, or damages resulting from lost data or business interruption) resulting from the use of or inability to use the Website, a Topic Website and the Content, including the Assessments, in excess of the fees paid, if any, for the Content, whether based on warranty, contract, tort (including negligence), or any other legal theory, even if such Foundation Party has been advised of the possibility of such damages. This limitation of liability may not apply in the event of lost PHI or your ability to access PHI.

4.6 Some states do not allow exclusion of implied warranties or limitation of liability for incidental or consequential damages, so the above limitations or exclusions may not apply to you. In such states, the liability of the Foundation Parties shall be limited to the greatest extent permitted by law.

You agree to defend, indemnify, and hold harmless the Foundation Parties from and against any claims, actions, or demands, including, without limitation, reasonable legal and accounting fees, arising or resulting from your breach of this Agreement or your access to, use or misuse of the Content, Website or any Topic Website. The Foundation shall provide notice to you of any such claim, suit, or proceeding. The Foundation reserves the right to assume the exclusive defense and control of any matter, which is subject to indemnification under this section.

In such case, you agree to cooperate with any reasonable requests assisting the Foundation's defense of such matter.

6.1 The Foundation reserves the right, in its sole discretion, to restrict, suspend, or terminate this Agreement and your access to all or any part of the Website, a Topic Website or the Content at any time and for any reason without prior notice or liability. The Foundation reserves the right to change, suspend, or discontinue all or any part of the Website, a Topic Website or the Content at any time without prior notice or liability.

6.2 Sections 2 (Use of the Website), 4 (Limitation of Liability and Warranty), 5 (Indemnification), 6 (Termination of Agreement), and 11 (Miscellaneous) shall survive the termination of this Agreement.

7.1 We make no claims concerning whether the Content may be downloaded, viewed, or be appropriate for use outside of the United States. If you access the Website, a Topic Website or the Content from outside the United States, you do so at your own risk. Whether inside or outside the United States, you are solely responsible for ensuring that your use of the Website, the Topic Website or the Content is in compliance with the laws of your specific jurisdiction.

7.2 The United States controls the export of certain products and information. You expressly agree to comply with such restrictions and not to export or re-export any of the Content to countries or persons prohibited under the export control laws. By downloading the Content, you expressly agree that you are not in a country where such export is prohibited or are a person or entity for which such export is prohibited. You are solely responsible for compliance with the laws of your specific jurisdiction regarding the import, export, or re-export of the Content.

The Content is provided with "Restricted Rights." Use, duplication, or disclosure by the Government is subject to the restrictions contained in 48 CFR 52.227-19 and 48 CFR 252.227-7013 et seq. or its successor(s). Use of the Website or Content by the Government constitutes acknowledgement of our proprietary rights in the Website and Content.

Depending on how you use the Website or a Topic Website, you may or must register an account. You may register an account with us for taking credentialing examinations, accessing information of interest and otherwise.

The GEM Topic Website permits patients to share PHI with their health care provider. We may refer to this type of account as a HIPAA Account. We will provide privacy and security for HIPAA Accounts in conformance with HIPAA regulations. In order to provide PHI to the GEM Topic Website, you must create a HIPAA Account with us and your health care provider must have a HIPAA Account through which he or she accesses your PHI. Further, your health care provider must sign our standard business associate agreement ("BAA"), in which we are the business associate of your health care provider. You and your health care provider must use your HIPAA Account in conformance with our privacy and security standards and in conformance with HIPAA regulations. If you do not, or your provider does not, we may terminate your account. Your registered account must be used in compliance with the Agreement and the BAA. In the event you use the registered account other than in compliance with the Agreement, we may terminate the registered account with or without notice to you. In the event we terminate your registered account, for any reason, we will not be responsible for any damages.

You understand that all information, data, text, photograph, graphics, messages or other materials publicly posted ("Posted Content") is the sole responsibility of the person from which it originated. This means you, and not the Foundation, bear all risks and liability for all Posted Content that you upload, post, email, transmit or otherwise make available via the service to:

1. upload, post, email, transmit or otherwise make available any Content that infringes any patent, trademark, trade secret, copyright or other proprietary rights ("Rights" of any party;
2. upload, post, email, transmit or otherwise make available any unsolicited or unauthorized advertising, promotional materials, "junk mail," "spam," "chain letters," "pyramid schemes," or any other form of solicitation. (Posting the same note more than once can be considered "spam" or "spamming");
3. upload, post, email, transmit or otherwise make available any material that contains software viruses or any other computer code, files or programs designed to interrupt, destroy or limit the functionality of any computer software or hardware or telecommunications equipment;
4. upload, post, email, transmit or otherwise make available any Content that is unlawful, harmful, threatening, abusive, harassing, tortious, defamatory, vulgar, obscene, libelous, invasive of another's privacy, hateful, or racially, ethnically or otherwise objectionable;
5. impersonate any person or entity, including, but not limited to, a Foundation official, forum leader, guide or host, or falsely state or otherwise misrepresent your affiliation with a person or entity;
6. forge headers or otherwise manipulate identifiers in order to disguise the origin of any Content transmitted through the Service;
7. disrupt the normal flow of dialogue, cause a screen to "scroll" faster than other users of the Service are able to type, or otherwise act in a manner that negatively affects other users' ability to engage in real time exchanges;
8. intentionally or unintentionally violate any applicable local, state, national or international law;
9. "stalk" or otherwise harass another; or harvest or otherwise collect or store personal data about other users.

This Agreement is governed by the laws of the State of Oklahoma, without respect to its conflict of laws provisions. You expressly agree to submit to the exclusive personal jurisdiction of the state and federal courts sitting in Oklahoma City, Oklahoma. If any provision of this Agreement is found to be invalid by any court having competent jurisdiction, the invalidity of such provision shall not affect the validity of the remaining provisions of this Agreement, which shall remain in full force and effect. Failure of the Foundation to act on or enforce any provision of the Agreement shall not be construed as a waiver of that provision or any other provision in this Agreement. No waiver shall be effective against the Foundation unless made in writing, and no such waiver shall be construed as a waiver in any other or subsequent instance. Except as expressly agreed by the Foundation and you, this Agreement constitutes the entire Agreement between you and the Foundation with respect to the subject matter, and supersedes all previous or contemporaneous agreements, whether written or oral, between the parties with respect to the subject matter. The section headings are provided merely for convenience and shall not be given any legal import. This Agreement will inure to the benefit of our successors, assigns, licensees, and sublicenses. Any information submitted or provided by you to the Website might be publicly accessible, except as otherwise provided in these Terms of Use and, specifically, the Terms of Use of the GEM Topic Website. Important and private information should be protected by you. The Foundation is not liable for protection of privacy of electronic mail or other information transferred through the Internet or any other network that you may use.

Privacy Policy and Legal Notices

The Perinatal Quality Foundation (referred to as "PQF") respects the confidentiality and the identity of visitors to perinatalquality.org (the "Website") and its related topic websites (each a "Topic Website"). By using the Website or Topic Website and participating in certain PQF programs, you will share important personal information with us, including but not limited to the name of your workplace, work demographics, telephone number, email address, credentials, and clinical role. This information will remain strictly confidential with PQF. It may be used for PQF administration and in an aggregate manner for research.

Nothing in this Privacy Policy applies to HIPAA privacy or security standards required to be implemented by the Foundation or protected health information ("PHI") you provide or submit to this website. As to any PHI, PQF has created and maintains specific privacy and security standards consistent with HIPAA. We have created specific HIPAA policies which cover the privacy and security of any PHI you submit to the GEM Topic Website. You should review those policies to identify our responsibilities regarding your PHI.

You understand and agree that we may change this Privacy Policy at any time without prior notice. If you maintain an active account with us, we will provide you an email notice of the change(s). You may read a current copy of these Privacy Protection Policy at any time by selecting the "Privacy Protection Policy" link on the website or by visiting http://www.perinatalquality.org/privacy. Any revised policy will become effective immediately after posting with your first use. Any use of the website after such posting shall constitute your acceptance of such revised policy. If any change to Privacy Protection Policy is not acceptable to you, your sole remedy is to cease accessing, browsing and otherwise using the website.

In order to use this site, such as to take examinations or review certain materials or our resources, you will be able to register and create a user account to allow you to have a more personalized user experience. You are responsible for maintaining the confidentiality of your user name and your password. Further, you are responsible for all activity on your account. PQF does not maintain any responsibility or have any liability for lost or stolen passwords or user names nor for any unauthorized use of your account. In the event your ability to access your account is compromised, please contact us immediately at support@perinatalquality.org.

We employ encryption software to prevent unauthorized use of information stored on our servers. In areas of the site where users must provide personal information for purchasing certain services, only relevant information will be forwarded via Secure Socket Layer (SSL) utilities in order to fulfill these requests.

Please be aware that we cannot guarantee that unauthorized third parties will never be able to defeat our security measures or use your personal information for improper purposes.

A cookie is a small amount of data that is transferred to your browser by a web server and can only be read by the server that gave it to you. Cookies enable us to identify your device or to improve your visit you when you have logged in. We use cookies only that are strictly necessary to enable you to move around the site or to provide certain features. Most browsers are set to accept cookies, but you can set your browser to notify you when you receive a cookie, thus allowing you to decide whether or not to accept it. If you set your computer not to allow cookies, you may not be able to use all of the features of the Website or a Topic Website.

Email addresses will only be utilized for PQF related alerts, including payment receipts. We will not share your e-mail address with any third party sources for any reason.

Access to information regarding an individual user's pass or fail status, specific score and number of questions missed per category ("User Results") is provided by PQF to the individual participant within a user generated password-protected account.

Hospitals or institutions purchasing the program for employees may access User Results for employees and a report providing, by name, employees in specific scoring quadrants and strengths and limitations of these groups.

If a participant self-pays for the examination, that participant's User Results will not be provided to their employer or others in any format without specific permission from the participant.

In the event that an institution purchases examinations for individuals, in addition to the User Results, the institution will receive an aggregate breakdown of scores for those individuals. The institution will be given group scores that may include specific quadrant ranking of individuals and specific educational needs for different quadrant groups.

Participants using an institutional payment method will receive notice during registration stating that composite results will be shared with the hospital/institution. All participants will have the opportunity to self-pay.

For participants who self-pay there will be a check box giving permission to share specific quadrant ranking information with an employer.

We want to keep you in control of the personal information you provide to us. Accordingly, you can review, correct, or change the personal registration information you provide to PQF by logging into your user account.

Though PQF makes every effort to preserve your privacy, PQF may need to disclose personal information when required by law where PQF has a good-faith belief that such action is necessary to comply with a current judicial proceeding, a criminal investigation, a court order, or legal process served on PQF. PQF may also share your personal information if PQF believes it is necessary in order to investigate, prevent, or take action regarding illegal activities, suspected fraud, situations involving potential threats to the physical safety of any person, violations of PQF or the Website's or Topic Website's Terms of Use [insert link to T&C], or as otherwise required by law.

If we decide to change this privacy policy, we will post the changes in places we deem appropriate so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If, however, we are going to use individually identifiable information in a manner different from that stated at the time of collection, you will be notified in advance by email, if you have provided us with a valid email address.

PQF welcomes your comments regarding this Privacy Policy. If you believe the PQF has not adhered to this Statement, please contact us at support@perinatalquality.org. We will use commercially reasonable efforts to determine and remedy the problem, if any.

In the event PQF goes through a business transition, such as a merger, acquisition by another entity, or selling a portion of its assets, users' personal information will, in most instances, be part of the assets transferred. We will not undertake a business transition without continuing to protect your privacy.

You agree that your access to, and use of, this site is subject to these terms and all applicable laws, and is at your own risk. This site and its contents are provided to you on an "as is" basis. The site may contain errors, faults, and inaccuracies, and may not be complete and current.

In no event shall any PQF party be liable to any user, beneficiary, or any third party for any damages whatsoever (including, without limitation, incidental and consequential damages, lost profits, or damages, including, without limitation, exemplary, special, incidental or punitive damages, resulting from lost data, disclosed information or business interruption) resulting from the use of or inability to use the Website, any Topic Website or the Content, including any Assessments, in excess of the fees paid for the Content, if any, whether based on warranty, contract, tort (including negligence), or any other legal theory, even if such foundation party has been advised of the possibility of such damages.

Some states do not allow exclusion of implied warranties or limitation of liability for incidental or consequential damages, so the above limitations or exclusions may not apply to you. In such states, the liability of the foundation parties shall be limited to the greatest extent permitted by law.

Neither the authors, nor the PQF nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete. Further, the authors, PQF and any other party above are not responsible for any errors or omissions or for the results obtained from the use of such information. Users are encouraged to confirm the information contained herein with other sources.

The Content of the Website or any Topic Website, including Assessment materials, is for the specific purposes described on the Website or Topic Website. It is not intended and should not be considered a substitute for professional medical advice, diagnosis or treatment. Do not use the information on the Website or any Topic Website for diagnosing or treating any medical or health condition. If you have or suspect any medical or health problem, promptly contact an appropriate healthcare provider.

If you have any questions about the privacy policy, please feel free to contact us. Email: support@perinatalquality.org.

Genetic Education Module (GEM)

The Genetic Education Module ("GEM") is designed as a resource to patients for timely, specific information concerning the utility, benefits, risks and nature of various types of testing and assessments available which may help identify fetal anomalies, including genetic and other concerns. The GEM Website allows patients to submit personal information which may be used to provide risk assessment results. In addition, the GEM Website allows health care providers to access their patient's GEM accounts (on an individual basis) in order to review patient information or provide additional information. The goal of the GEM Website is to improve communication and understanding by patients regarding assessment options during pregnancy based on their individual circumstances.

The GEM Website is not a substitute for an actual doctor-patient relationship and should be used only in conjunction with a current doctor-patient relationship. The Perinatal Quality Foundation ("PQF") strongly discourages anyone from attempting to self-diagnose any aspect of fetal health. To be clear: Do not use the GEM Website for self-diagnosis purposes.

Fetal testing and assessment for anomalies may take many forms, from non-invasive to minimally invasive to invasive. The types of tests or assessments likewise vary in accuracy and risks posed. Risks may include miscarriage. Some tests and assessments may result in false positive and false negative results. Nonetheless, tests and assessments can be critical tools in helping each patient prepare for and make important decisions regarding pregnancy. If it important that you fully understand how to use the assessment tools and the GEM Website if you decide to use any of them.

Some information about types of tests and assessments available to pregnant women is available on the GEM Website without an account. Other information requires an account and may require your health care provider to have an account. Because your physician may access, use, review or transmit the information you provide on your account, we consider this information to be protected health information ("PHI") as defined by HIPAA regulations. 42 CFR Parts 160 and 164. In order for you and your provider to communicate through the GEM Website, we will enter into a business associate agreement ("BAA") with your provider. A BAA identifies, in part, our responsibilities regarding your PHI relative to your provider.

We also have implemented privacy and security policies and procedures in order to comply with the physical, technical and administrative security requirements and privacy requirements of HIPAA. You may review our HIPAA policies and procedures here.

PQF does not perform any genetic testing. No test or assessment on the GEM Website performs genetic testing, as it is commonly defined. In the event you undergo prenatal genetic testing and that information is uploaded to your account, we will maintain the confidentiality of that information pursuant to our HIPAA policies and procedures. We will comply with the Genetic Information Nondisclosure Act ("GINA") through our HIPAA policies and procedures. In the event you live in a state with specific genetic testing privacy and security requirements, we will comply with those requirements to the extent they apply to us. No other PQF website, such as the NIPT/cell free DNA website or the NT Calculator Website permit you to upload PHI or permit your physician secure access to any account you might create or maintain. As such, we do not provide HIPAA security and privacy policies and procedures to those sites.

By using the GEM Website, creating an account, uploading your PHI and permitting your physician to access your information, you acknowledge and agree as follows:

1. PQF is not a health care provider and does not diagnose or treat any condition. We are not your health care provider and you will not use us as one.
2. You will not use the GEM Website or any information contained on or provided through the GEM Website to diagnose or treat any condition.
3. You will use the GEM Website only in conjunction with a valid doctor-patient relationship of your own choosing.
4. PQF cannot interpret or further explain any of the pregnancy testing and assessment information provided on the GEM Website. If you have questions about any of the testing or assessment information on the GEM Website, you should ask your provider.
5. PQF cannot be responsible for your use or misuse of the GEM Website.
6. All terms and conditions of the PQF Website, including your release and indemnification provisions, apply to your use of the GEM Website, except as may be specifically limited by HIPAA or GINA.
7. We may use your de-identified data to promote PQF's educational and informational efforts. To do this, we may extract certain de-identified data in a manner which complies with HIPAA and GINA regulations and use that data in ways which support the efforts of PQF programs. You further agree that de-identified data may be considered our data.

The GEM Website is intended for use in the United State of America and its territories. Use in any other place is at the user's own risk. We do not state or guarantee the GEM Website complies with requirements imposed in any other jurisdiction.