Spouse Informed, Consent and Service Agreement


Informed Consent

This is an informed consent and an agreement (“Agreement”) between ImmuneCyte Life Sciences, Inc. (“ImmuneCyte” or “We”) and you, the donor (“Client or You”) with respect to and for services as described herein. ImmuneCyte’s services are designed to preserve the mononuclear cells found in your peripheral whole blood through a cell banking process, with the intent of preserving them for potential future medical treatments.

Honestly Complete All Forms.

You understand that you must read, understand, honestly complete, and sign all the forms included in this packet (constituting this Agreement) in order to receive ImmuneCyte’s services.

You Are Bound by the Terms of this Agreement:

In particular, by signing this Agreement you acknowledge, consent and willingly agree that:

  • You enter into this Agreement voluntarily and without pressure or coercion.
  • You will receive a copy of our Quality Product Guarantee, and that this Quality Product Guarantee (including the limitations set forth therein) constitutes the sole guarantee with respect to our services and replaces all other guarantees whether express or implied and whether or not otherwise existing or available under law.
  • There is a $200 enrollment fee payable once you enter into this Agreement, and such fee is non-refundable.
  • A Medical Health Questionnaire will be completed by you as part of the enrollment process.
  • You agree to release (and provide and necessary authorizations to clinicians/providers as may be required for its/their release of) your medical history and records to ImmuneCyte and your physician prior to the release of your blood for medical use.
  • You agree to provide your family’s medical and genetic history, and such other information as reasonably requested by ImmuneCyte.
  • You agree to inform ImmuneCyte of your health information should you develop a disease that may cause risk to the recipient of, or persons handling, the blood.
  • A medical professional contracted by ImmuneCyte (“Medical Professional”) is permitted to collect your peripheral whole blood, and you agree that ImmuneCyte will release your contact information to medical professional and you will execute such forms as requested by the provider for such purposes, including forms allowing the release of the blood (and associated information) to ImmuneCyte.
  • ImmuneCyte, or an outside lab, is permitted to test the blood, for infectious diseases.
  • Your consent and agreement to these and the other terms of this Agreement is necessary to permit ImmuneCyte to perform hereunder.

Your Blood will be Tested.

It will be important for ImmuneCyte to test your whole blood for traits that will help confirm whether it is eligible for storage (“Tests”). You will need to have your blood taken and sent to ImmuneCyte. You understand that, while ImmuneCyte does not take/draw your blood, there are risks to having a sample of your blood drawn, which may include bruising, redness, discomfort, or inflammation around the insertion site. You consent to the conduct of the Tests or arranging for a third party to conduct the Test on your blood. The Tests will include tests for HIV, hepatitis B and C, HTLV I/II, syphilis, as well as for other conditions required by federal, state and local government and regulatory agencies, and/or otherwise related to the suitability of the blood for storage. If and as required by applicable law and/or regulation, ImmuneCyte may be required to report the Test results to such federal, state and local government and regulatory agencies; you hereby acknowledge and consent to such mandatory reporting by ImmuneCyte. In such mandatory reporting instances, ImmuneCyte will only disclose and report such information as required to comply with applicable law.

You agree to permit ImmuneCyte to collect and Test your blood. If the first Test indicates that you carry one of these diseases, a second Test will be performed for accuracy. If the Test results are confirmed positive for HIV, the blood will not be stored. If the blood Tests indicate the possible presence of any other infectious agent or the tests are inconclusive, the blood unit will be processed and cryopreserved only with the approval and sole discretion of ImmuneCyte’s Medical Director. ImmuneCyte will provide you with the results of these Tests. ImmuneCyte will provide a complete list of Tests to be performed on your blood upon your written request. You will authorize disclosure of these Test results in connection with the release of the blood. Without this authorization, it may not be possible to use the blood in medical therapies. If the blood sample is not collected and/or cannot be adequately Tested, this may preclude the cells from being used in medical treatments due to regulatory requirements. ImmuneCyte may, in its sole discretion, retain a copy of any Test results and will retain any Test results as may be required by and for the period required by, applicable law.

Collection of Your Blood

Medical Professional will collect your blood. ImmuneCyte will provide the necessary collection materials; however, Medical Professional is solely responsible for the collection process, including the proper labelling and packaging of your blood. Failure to properly collect, label, or package your blood may prevent ImmuneCyte from performing its services, and ImmuneCyte may reject any blood that ImmuneCyte determines, in its sole discretion, has been improperly collected, labeled or packaged. ImmuneCyte shall not have any responsibility in connection with the collection, labeling or packaging performed by Medical Professional.

When ImmuneCyte’s Services May Not be Available.

Your health and providing a service of value are of utmost importance to us at ImmuneCyte, and sometimes preserving these values mean that we cannot provide our services to you. For example, whether the blood can be safely collected at the time of your appointment is entirely the decision of Medical Professional. If it is not safe for you or for any other reason in the sole discretion of Medical Professional, then the blood will not be collected. Furthermore, if the blood is made unusable for reasons including, but not limited to, incorrect collection method, the collected blood is not returned to ImmuneCyte for preservation in time, there was not enough time to arrange for ImmuneCyte’s services, wrong delivery place, the amount collected is too small and/or the amount collected cannot be processed in accordance with ImmuneCyte’s protocol, signs of bacteria are visible, the collector does not use ImmuneCyte’s collection kit and/or its contents, an ImmuneCyte label is not affixed directly to the collection bag or blood tubes, and/or a viral or genetic reason the sample does not meet company standards, then ImmuneCyte would not be able to provide the level of service you are entitled to or ImmuneCyte’s services may not be available. To this end, ImmuneCyte cannot guarantee that it is able to preserve the blood.

Benefits and Risks.

Recent scientific developments have allowed for the culture of T cells obtained from peripheral blood to be used as a form of immunotherapy that uses specially altered T cells, to fight cancer. Currently a person’s own cells show the greatest potential to be used by that person (as opposed to using someone else’s cells). As with any new, experimental procedure, there are risks but it is hoped that this technology will be able to be applied to many different medical uses where using the patient’s own cells is a benefit, or requirement, in a medical treatment. ImmuneCyte currently makes no guarantee that these or any other cellular therapy treatments will work, will be a match for any family member, that any treatments that do exist will apply to you, or that you will ever need it. There is still the risk that using your cells could cause organ damage, failure to engraft, disease, complications, illness, and even death. ImmuneCyte’s sole obligation hereunder is with respect to the initial Tests and storage of your blood. The use of cryopreserved cells for future immunotherapies is not guaranteed. Much is yet unknown about the future of immunotherapy and the immune cells that have been cryopreserved. The use of cryopreserved cells by commercial manufacturers for CAR-T therapy production is not currently approved by the FDA. There is active research ongoing, however, there is no guarantee that your cryopreserved cells will have a future therapeutic use. That is why it is important to talk to your treating physicians about this. Obviously, you are taking steps today that will hopefully be of benefit to you in the future on the belief that treatments and science will develop beneficial uses for this blood.

Your Information

In connection with ImmuneCyte’s performance of its services, you understand that you may provide ImmuneCyte with your protected health information or other confidential information, and/or that ImmuneCyte may collect, retain, develop or generate information about you that is considered protected health information. Collected information may include your name and your date of birth, Test results, along with protected health information and information about your general health condition and medical history (collectively herein “Information”). ImmuneCyte will possess and store the Information, and may use and disclose the Information for the purposes of performance of services hereunder and as required to comply with applicable laws. ImmuneCyte may disclose the Information to its agents, representatives and affiliates, to medical provider, to such providers and entities that you authorize ImmuneCyte to make disclosures to, and to such regulatory or governmental agencies as may be necessary for purposes of complying with law. Once your Information has been given to ImmuneCyte, it may no longer be protected by federal laws and regulations and might be further disclosed by ImmuneCyte.

If you sign this Agreement and consent form, you are giving permission for the use and disclosure of your Information for purposes set forth in this Agreement in relation to the services. You do not have to give this permission. However, if you do not, you will not be able to receive the services. If you give consent for use and disclosure of your Information, it will not expire. You do have the right to revoke (take back) your consent, at any time, by notifying ImmuneCyte. If you revoke your consent, ImmuneCyte will not collect any new personal information about you; however, it can continue to use and disclose any already collected Information.

Acknowledgement and Consent.

By signing here below, you acknowledge you have read this Consent and Service Agreement, and fully understand and agree to its terms, rights, and obligations, including to the right of ImmuneCyte to receive, use and disclose your Information as contemplated herein. Further, that you acknowledge that you have been given the opportunity to ask questions about this Agreement and that all of your questions have been answered to your satisfaction.

 

 

Service Agreement

ImmuneCyte Provides the Kit.

ImmuneCyte will provide a blood collection kit to you (herein “you,” “your” or “Client”), to take to your appointment with your Medical Professional. We will also provide you with information to give to your Medical Professional who will be collecting the blood, whether that is a physician, nurse, or other person you authorize to do this for you (“Medical Professional”). It is essential that you arrange for collection of the blood with your Medical Professional. You are responsible to bring your ImmuneCyte Collection Kit to where you are going to have your blood collected, and to use the ImmuneCyte Collection Kit.

ImmuneCyte Will Process, Preserve and Store the blood, subject to limitations noted in Informed Consent.

We will process the blood using the automated method or the manual method according to ImmuneCyte’s laboratory procedures. If we determine that blood is suitable for storage and the processing of the blood is complete, we will cryopreserve, and store the unit in a cyrobag in liquid phase nitrogen at -196°C (minus one hundred and ninety-six degrees Celsius) until such time that you request it, or this Agreement terminates, whichever comes first.

Completion of Forms.

It is very important that you agree to read and complete all of the forms in this package. We hope you understand that ImmuneCyte cannot provide our services to you until you do this, because we want you to be fully informed.

Your Scheduled Collection Date.

You will inform ImmuneCyte of your scheduled collection date. It is important that we know this so that we can prepare to give you the best service. Please enroll as early as possible.

Use of a Medical Professional.

You will choose Medical Professional and inform him or her of the plan to collect your blood. The Medical Professional shall not be construed to be an employee of ImmuneCyte. The Medical Professional is not the agent of ImmuneCyte and is in no way affiliated with ImmuneCyte or its parent company. ImmuneCyte assumes no responsibility for assessing the qualifications of your hospital(s), physician(s), or other Medical Professionals. You agree to sign such authorizations and forms as may be required by law and required by Medical Professional to sign so that s/he may disclose information about you to ImmuneCyte for service performance.

Notification upon Collection and Transport of Collected Blood

You are responsible for following the shipping procedures and instructions included in the collection kit. You or your Medical Professional will need to contact ImmuneCyte as soon as possible once the blood has been collected, at 1-800-803-7854. ImmuneCyte uses FedEx or employs its own Medical Courier who, once notified, will pick up your blood and deliver it directly to our lab. ImmuneCyte has the

right to use a third party courier service if needed. Alternatively, you may use a courier of your choice. Should you do so, you understand that ImmuneCyte is not responsible for third party courier transport of your collection kit to ImmuneCyte’s facilities. Client agrees that ImmuneCyte is not liable for loss, destruction to, or deterioration of the blood prior to receipt at ImmuneCyte’s facilities. The blood should be kept with you or your Medical Professional at all times at room temperature prior to pick-up. If client lives outside of the metro area that ImmuneCyte operates and outside of 15 miles of radius to a nearby airport, Client agrees to be responsible for paying courier cost to deliver blood to the ImmuneCyte facility.

Change of Client Information.

Client is responsible to inform ImmuneCyte of all changes in address, contact information, payment information or changes to any other information provided to ImmuneCyte throughout the term of this Agreement.

Fee Schedule.

The Fees to be paid under this Agreement are set forth on the fee schedule.

Payment for Services.

Client agrees to pay a $200 non-refundable enrollment fee and all of ImmuneCyte’s fees for the services you request. If you fail to make a required payment, we will make attempts to contact you prior to Agreement termination and send you a written notice at the address you provided to us.

Minimum Contract Term.

Client agrees to commit to a minimum 36-month contract. If client wants to terminate the contract early after the blood is processed and stored, client will have to pay an early termination fee equal to 36 months of monthly fees, less any monthly fees previously paid by Client. If Client enrolls in the lifetime storage plan, the blood will continue to be stored at no additional cost beyond 60 years for the life of the Client. If the unit(s) is used for a cellular therapy or other treatment prior to the 60 years, the storage fees will be pro-rated and refunded as applicable.

Reinstatement of Account.

If client wishes to reinstate the account after the account is terminated, client will be liable for all storage fees up to the point of reinstatement. This includes yearly/monthly storage fees that have accrued between the time of termination, and time of reinstatement. ImmuneCyte will only reinstate the account if the stored blood is still available.

Payment.

Cancellations prior to processing and storage are subject to the $200 initial enrollment fee. If client is enrolled in a monthly plan, the initial enrollment fee and first month payment is due on the contract signing date. The blood storage fee will be automatically charged to the credit card or Auto-Debit account/ACH on file when due monthly. Client will be responsible for all fees associated with the processing and storage of the blood. If client is enrolled in a prepaid plan, the entire prepaid payment is due on the contract signing date.

Agreement Termination.

You may terminate this Agreement for any reason and have the right to specify the disposition of your blood to a designated location or physician which is authorized under applicable law to receive blood. ImmuneCyte will communicate transfer requirements to Client. Such requirements include the following: (a) Client’s identity must be verified, (b) Client must identify an entity that is able to receive the blood in compliance with all regulations and requirements, (c) signed consent by all parties, including but not limited to client, for release of the blood and any associated Client information, (d) the receiving entity must complete all ImmuneCyte-required documentation in support of the transfer, (e) Client and receiving entity will be responsible for the transportation (f) Client will be responsible for all fees associated with the transfer (g) Client and receiving entity must agree to hold ImmuneCyte harmless for any losses or damages in association with the transferred blood. Upon transfer of the blood, the ImmuneCyte Product Guarantee will no longer apply.

Your Agreement with ImmuneCyte will be deemed terminated if:

  1. Your scheduled collection date has passed by thirty (30) days and you have not contacted ImmuneCyte to schedule the blood pick-up;
  2. Your account is overdue for more than sixty (60) days;
  3. Your voluntary termination for any reason upon a written notice in advance.

In the event of Agreement termination and no instructions are received 30 days after any event of the termination has occurred, ImmuneCyte has the right to dispose of your blood for value or otherwise, without notice to you. You will not be entitled to any refund or compensation, you waive your rights in and to the blood (including ownership) and/or information that may be derived from the blood, and ImmuneCyte will retain all rights to the blood unit. ImmuneCyte shall have no further liability or obligations to Client with regard to the blood. If your account is terminated after the payment is due for sixty (60) days, you will be liable for the overdue payment plus storage fee for 60 days. ImmuneCyte may also charge for any collection agency fees billed to us for trying to collect from you. If Client requests to voluntarily terminate this Agreement after the blood has been processed and stored, ImmuneCyte will not issue a refund of any fees charged and has the right to charge Client a minimum of storage fee equivalent to three year contract terms for the processing of blood and/or the incurred cost to process and store the blood if client is on the monthly payment plan. If client is on the prepaid plan, no refund will be issued if client requests to voluntarily terminate this agreement.

Refund of Unused Years of Storage.

If you decide to retrieve your blood for clinical use prior to the end of your prepaid storage years, then you will be issued a refund. Your refund will be the remaining amount from the prepaid storage fees after deducting applicable discount(s) and used storage fee(s).

Your Rights to the Blood.

You agree that you are over 18 years of age, and understand that ImmuneCyte will treat you as the sole designated contact for all purposes relating to this Agreement, including but not limited to retrieval and use of the blood, your account information, updating of contact information, payment of fees, and termination of this Agreement. If you wish to assign your rights and obligations under this Agreement to a third party, both the third party and ImmuneCyte must agree in writing. The third party must sign a new Service Agreement with ImmuneCyte to confirm his or her understanding and agreement of the terms and conditions of the Service(s). You understand that once you assign the rights and obligations under this Agreement to a third party, this Agreement will become null and void.

What Happens When You Need Your Blood

You will have the right to request the use of your blood. If you need the blood, you agree to notify ImmuneCyte in writing a minimum of two (2) weeks prior, to prepare and ship the stored blood to a designated location or physician which is authorized under applicable law to receive blood. You will arrange for and be responsible for shipping and payment of all transportation fees. Upon release of the blood to your designated courier, ImmuneCyte will be released of any and all responsibilities and liabilities including any loss, destruction, or deterioration of the blood, and the Client and receiving entity shall hold ImmuneCyte harmless for any losses or damages in association with the transferred blood. If you request any future testing of the blood, or related tests, you agree to pay for it. ImmuneCyte will then release the blood to your shipper and/or cause the test(s) to be performed. ImmuneCyte may not release the blood to a designated location or physician for non-medical treatment in accordance with applicable laws and regulations concerning research on human subjects, as well as any requirements stipulated by the facility’s independent ethics committee are followed.

Processing and Storage of blood

ImmuneCyte has the right to determine if the blood is suitable for storage. ImmuneCyte will not process the blood if after initial inspection the blood is visibly contaminated upon receipt of the blood and/or the condition of the blood does not meet ImmuneCyte’s protocol.

When ImmuneCyte’s Service Cannot Continue.

If, for any reason, ImmuneCyte is unable to continue to provide storage services, your sample will be transferred at no cost to you to another facility (as determined by ImmuneCyte) which is authorized under applicable law to receive and store blood. If Client selects a facility not chosen by ImmuneCyte, this Agreement will be terminated, Client will not be entitled to any refunds and will be subject to the terms noted in Agreement Termination.

Confidentiality.

ImmuneCyte agrees to use reasonable efforts seeking to maintain confidentiality of information provided by you please be advised the treatment of your protected health information is addressed in the consent form). This provision shall be deemed not to restrict disclosure, including disclosure of protected health information as authorized by you in the consent form, required by law, requested by any government agency or public authority, inadvertent disclosures due to unintentional release of information, disclosures resulting from media attention, disclosures made by individuals, whether or not employed by ImmuneCyte, disclosures of information resulting from computer hacking, or any other type of intruder acting without company authorization, release of information to your Medical Professional and any medical associations he or she may be affiliated with, such as the facility you are scheduled to have your blood drawn, laboratory, or anyone for the claimed purpose of providing health or medical services to you, or disclosures to professional consultants or advisors to ImmuneCyte, or disclosures as part of a potential or actual sale, transfer or assignment of any or all rights or obligations of ImmuneCyte under this Agreement. ImmuneCyte will keep confidential information that could identify you, except if such disclosure is authorized by you, required to fulfill the services described in this Agreement, or required by law. Confidentiality will continue even after cancellation, termination or expiration of the Agreement.

No Warranty.

You acknowledge that neither ImmuneCyte, its affiliates, successors, assignees, officers, directors, employees, agents, independent contractors, or subcontractors have made any representations, guarantees or warranties, express or implied, to you of any type or nature, including without limit, the generality of the foregoing, warranties or guarantees (except as stated in ImmuneCyte’s Quality Product Guarantee, enclosed) with respect to (1) the therapeutic, or other value of whole blood, either now or in the future, (2) that you may ever need the blood, (3) the suitability of the blood for the use of another family member, (4) the guaranteed success of collecting the blood, (5) the suitability of the blood for storage, (6) the deterioration, loss, degradation, or spoilage of the blood, or (7) the merchantability or fitness for a particular purpose or use of any product or service hereunder. ImmuneCyte is not a medical provider, performs no medical services and gives no medical advice. You should consult with your Medical Professional with respect to any medical treatment, diagnosis or services.

Release, Limitation of Liability and Indemnification.

 

You, on behalf of yourself, release ImmuneCyte, its affiliates, its shareholders, directors, officers, employees, agents, affiliates, insurers, professional advisors, attorneys, service providers, successors, and assignees from any and all liability for any and all loss, harm, damage, or claim of any kind related to the receipt, collection, handling, processing, storage, preserving and maintenance of the blood or otherwise in connection with the services, as well as any damages whatsoever arising or resulting from the action of others, including your Medical Professional, the hospital staff, and the shipper who transports your blood.

You, on behalf of yourself, acknowledge that, by the releases in this Agreement, you give up any right you may have now or in the future to sue or otherwise seek money damages or other relief against ImmuneCyte for any reason related to the receipt, collection, handling, processing, preservation storage, and maintenance of the blood or otherwise in connection with the services. You, on behalf of yourself, acknowledge being aware of, or now learning, Section 1542 of the California Civil Code, which provides: A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release which, if known by him, would have materially affected his settlement with the debtor.

You, on behalf of yourself, waive all rights under Section 1542 of the California Civil Code or similar laws in any applicable jurisdiction, for any claim arising out of or relating to a matter released herein.

ImmuneCyte does not guarantee against any possible loss, degradation, spoilage, contamination, or the like of any portion or all of the blood for any reason, including without limitation, as a result of ImmuneCyte's negligence or as a result of circumstances beyond ImmuneCyte's control such as, without limitation, war, fire, terrorist attacks, power outage, or natural disaster. ImmuneCyte and its related parties are responsible only for exercising ORDINARY CARE in connection with providing its services herein and will not be liable for any damages other than as described in this paragraph. You, on behalf of yourself, agree that if ImmuneCyte is found liable for gross negligence or willful misconduct, the amount of damages you may incur shall be limited to the amount of money paid by you and your heirs, successors, and assignees pursuant to this Agreement. You understand and agree that ImmuneCyte is not responsible for, and assumes no direct, indirect, punitive, incidental, special, or consequential damages. ImmuneCyte expressly disclaims any express or implied warranties of merchantability or fitness for a particular purpose.

You, on behalf of yourself, agree to indemnify, defend, and hold ImmuneCyte, the hospital, physicians, medical staff, your Medical Professional (and its/his/her associated or affiliated medical facility, physicians and staff), and each of their respective shareholders, members, directors, officers, managers, employees, agents, affiliates, insurers, professional advisors, attorneys, service providers, successors, and assignees harmless from any and all claims, liabilities, demands, and/or causes of action asserted by you or other person(s) for whose benefit the blood is being collected and stored. Client shall also indemnify and hold harmless ImmuneCyte, its affiliates, their respective directors, officers, employees, attorneys, agents, subsidiaries, subcontractors, and assignees from and against all claims, damages, judgments, attorney’s fees, costs and liabilities resulting from (1) the acts or omissions of the Client, Client’s Medical Professional, and/or courier transportation, and (2) the failure by Client to perform his/her obligations according to the terms and conditions of this Agreement. In no event shall ImmuneCyte have any obligation to indemnify, defend or hold you harmless for any claims, damages, liabilities, costs, or expenses arising or resulting, directly or indirectly, out of blood collection or ImmuneCyte's services to you.

Waiver.

This is our Agreement on how we will address any issues that arise between us and, as such, you agree to waive any other legal claims you may have against us that are outside the scope of what we agree to in this Agreement.

Governing Law, Jurisdiction, and Venue.

In the event of a dispute arising from this Agreement or its interpretation, the laws of the State of California shall control jurisdiction and venue for any such dispute shall be in the Federal or State courts located in Orange County, California. Parties hereto also agree that (1) the Agreement is made and entered into, (2) the obligation is incurred and to be performed, and (3) the Client is to make payments in Orange County, California. Client hereby submits to the above jurisdiction and venue for any purposes dealing with this Agreement or any subsequent agreement between the parties. This Agreement has been prepared in the English language and the English language shall control its interpretation.

Future Laws.

In the event the government passes new laws or changes existing ones, you acknowledge ImmuneCyte’s right to change or modify its procedures in order to comply with these new laws or changes to existing laws, and may pass on to, and/or require you to bear some or all of the costs associated with these changes.

Arbitration.

All disputes, which arise under this Agreement, shall be referred and resolved by a single arbitrator mutually acceptable to both parties. Arbitration shall be conducted in California. Sections 1280 to 1289 of the California Code of Civil Procedure shall govern.

Your Representations and Warranties.

In addition to the other representations and warranties you have made in this Agreement, you represent yourself, and warrant that you were advised to obtain medical and legal advice prior to signing this Agreement, and that your decision to enter this Agreement and abide by its terms was completely voluntary. In the event that this Agreement is terminated; ImmuneCyte will have the right to dispose or use the blood as set forth herein.

Sole Agreement.

This is the entire Agreement between you and ImmuneCyte. Any prior representations, statements, negotiations, omissions, or Agreements that precede this Agreement are integrated into and superseded by this Agreement and are null and void.

Modification.

Subject to the paragraph above regarding future laws, this Agreement cannot be modified without the written consent of both parties.

Assignment.

ImmuneCyte may assign this Agreement to any individual, association, partnership, or corporation that is either providing a similar service or intends, subsequent to such assignment, to provide a similar service, whether or not as part of a sale, transfer, or assignment of all or part of ImmuneCyte’s business, or for other reasons or in other circumstances, and ImmuneCyte shall require that this Agreement remain in full force and effect.

Death or Disability.

In the event of your death or disability, ImmuneCyte shall be entitled to rely on the instructions of your estate, guardian, conservator, trustee, administrator, or other similar responsible person or successor in interest.

Data Collection and Study.

You acknowledge and allow on behalf of yourself that ImmuneCyte shall have the right to aggregate and de-identify data, provide aggregate de-identified data to others for any purpose, to use information obtained through services provided to you, for purposes of research, development, marketing, applying for patents, licensing, and other development and use of intellectual property, or know-how, whether or not any of these activities are intended to or actually benefit or generate revenue or profit to ImmuneCyte provided that personal identifiers are removed and confidentiality is maintained. ImmuneCyte's only obligation to you is to use reasonable efforts to avoid disclosure of information that specifically identifies you.

Force Majeure.

If the performance of this Agreement, or any obligations arising under this Agreement, is prevented, restricted, or interfered with by reason of fire, earthquake, flood, or other casualty or accident, strikes, labor disputes, war or other violence, any law, order, proclamation, ordinance, demand, or requirement of any government agency, or any other act or condition beyond the control of ImmuneCyte, ImmuneCyte shall not be liable to you.

Method of Execution.

This Agreement will be fully enforceable and binding upon ImmuneCyte's receipt by online submission, email, or facsimile of your manual signature executing this Agreement and, where required, in its related documents.

Survival.

All covenants and Agreements made in this Agreement that, by their terms, require performance after termination of this Agreement, shall survive the termination of this Agreement.

Severability.

If any provision of this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions shall, nevertheless, continue in full force and effect without being impaired or invalidated in any way.

Binding.

All of the obligations, terms, provisions, and releases set forth in this Agreement shall be binding upon and inure to the benefit of ImmuneCyte and you, as well as to each party’s respective heirs, personal representatives, successors, and assignees.

Authorizations.

Each party to this Agreement represents that all authorizations, consents and approvals that are conditions precedent to the authority of such party to execute this Agreement have been obtained.

Language of this Agreement.

The language of this Agreement shall be construed as a whole, according to its fair meaning, and not strictly for or against any other parties hereto, as though each had participated equally in drafting each and every provision hereof.

Independent Legal Counsel.

Client hereby agrees that the Client has been advised to seek independent legal counsel to review this Agreement before executing the same, and that they have had adequate opportunity to do so. Client further acknowledges that at no time Client has relied upon any advice from ImmuneCyte and/or its Attorneys as to the effects of signing this Agreement.

Headings.

The titles appearing at the beginning of the paragraphs of this Agreement are for convenience only and shall not affect the interpretation of the Agreement.

Acknowledgement and Consent.

By signing here below, you acknowledge you have read this Informed Consent and Service Agreement, and fully understand and agree to its terms, rights, and obligations. Further, that you acknowledge that you have been given the opportunity to ask questions about this Agreement and that all of your questions have been answered to your satisfaction.

 

 

Fee Schedule

 

 

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Signed by HealthBanks Client Service
Signed On: July 22, 2020

Signature Certificate
Document name: Spouse Informed, Consent and Service Agreement
lock iconUnique Document ID: d25774f99eb16b52ceda6ed64219d849d5dc087f
Timestamp Audit
June 8, 2020 12:13 pm PSTSpouse Informed, Consent and Service Agreement Uploaded by HealthBanks Client Service - info@healthbanks.us IP 174.112.185.120
July 16, 2020 7:42 am PSTHealthBanks Admin - info@healthbanks.us added by HealthBanks Client Service - info@healthbanks.us as a CC'd Recipient Ip: 174.112.185.120