Student & Parental Consent

Dear Student:

 

As we work to resume normal operations, we continue to be concerned for your well-being during these unprecedented times. The School/University is taking reasonable steps to provide as safe a working environment as possible for our community during the COVID-19 pandemic. For example, we are implementing specific protocols to ensure proper social distancing, use of recommended or required personal protected equipment, regular and proper handwashing and hand sanitizing, enhanced disinfecting and cleaning of common areas. The School/University will provide you further details about the specific protocols applicable to your location. We will also continue to monitor guidance from the Centers for Disease Control and relevant state and local health authorities and update our protocols accordingly.
 

In the meantime, we need to ensure that all individuals who are experiencing symptoms of COVID-19 are tested promptly before returning to regular activity on campus. Thus, prior to reporting to campus, you will be asked to provide and disclose to the School/University certain information regarding any potential COVID-19 exposure or COVID-19 symptoms you may be experiencing, using miinehealth, a platform offered by justmiine, Inc. miinehealth is a remote health-monitoring platform through which you will report your temperature, symptoms, if any, and other screening information prior to entering the campus each day. This information will be reviewed by the School/University or by qualified medical or clinical professionals to help ensure persons who may be experiencing symptoms of COVID-19 do not report to campus.  If you are experiencing an elevated temperature and/or certain other COVID-19 symptoms, miinehealth will instruct you not to return to campus until you have visited a healthcare provider and been tested for COVID-19.  Through miinehealth you may engage with health care providers who can assess your symptoms and order you a COVID-19 home test; receive the ordered COVID-19 home tests from a laboratory; discuss your test results with the health care professionals; and justmiine via miinehealth will notify the School/University of your test results so we may work with you to determine next steps.  These services will be provided at no cost to you.
 

Given the nature of the COVID-19 situation, we cannot and do not warrant that the measures we have and will implement, including remote health monitoring through miinehealth, will fully protect anyone from exposure to COVID-19. Even with the best safety precautions and health monitoring, we all assume risk when we interact with others on campus and in society. Precautionary measures and remote health monitoring are also not intended to be a substitute for professional medical advice, health and safety measures recommend by governmental agencies, or good practices, such as social distancing, staying home when sick, and frequent hand washing. Further, each of us has a responsibility to adhere to campus health and safety rules.  You may not act in a manner as to endanger yourself or others. If you engage in conduct that jeopardizes the health and safety of yourself or others, you will be subject to discipline consistent with the School/University’s policies. If you have any questions or concerns, you may direct them to your School/University.
 

By signing below, you acknowledge, understand, consent, and agree as follows*:
 

• You consent to and authorize the School/University to disclose personally identifiable information via miinehealth to justmiine, including your name, student identification number, and other identification information for purposes of monitoring symptoms and potential exposure to COVID-19. 
   

• You understand your assumption of risks associated with being present on campus during the COVID-19 pandemic, as well as your responsibility to adhere to health and safety rules for your own safety and the safety of others.
   

• You consent to and will abide by all policies, procedures, practices, protocols, and measures implemented by the School/University to protect the community in the age of COVID-19, including, but not limited to, use of miinehealth.
   

• You understand your obligation to provide timely, truthful, and accurate information through miinehealth, including information regarding any COVID-19 symptoms you may be experiencing.
   

• You consent to the disclosure of medical information obtained through miinehealth and process to the health care providers made available for consult by justmiine/the School/University through miinehealth.
   

• You consent to the disclosure to justmiine and the School/University of the results of any COVID-19 test initiated through miinehealth.
   

• You will notify your School/University immediately, if any of your consents, acknowledgments, understandings, and agreements in the bullet points above change prior to entering the campus.
   

* If the student is under the age of 18, signature from a parent or legal guardian is required.

 

* If the student is under the age of 13, signature from a parent or legal guardian on the Parental Consent Form for Children’s Information is required.

 

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miinehealth Parental Consent Form For Children's Information

Direct Notice to Parents

 

In accordance with the Children’s Online Privacy Protection Act (COPPA) parents and legal guardians of children under 13 years of age must consent to certain collections, uses and disclosures of the personal information of their children collected by justmiine Inc. through miinehealth, justmiine’s our Website or App platform. Additional information about your rights under COPPA can be found out www.COPPA.org. The information in this Consent Form and notice supplements our Privacy Policy which can be found at https://www.miinehealth.com/privacy-policy.

 

Because our Website and App can be used for the collection of health information, we also require parental consent for minors under the age of 18.

 

We may have collected your online contact information from your child, as well as the name of the child or the parent, in order to obtain your consent. Your consent is required for the collection, use, or disclosure of information from your child. We will not collect, use, or disclose any personal information from your child if you do not provide such consent.

 

If you consent, we will collect, import, aggregate and analyze personal information from your child, including name, address, email address. Additionally, we may collect certain health and medical information through our Website or App. If you do not provide consent within a reasonable time from the date this notice was sent to you, we will delete your online contact information from our records. 

 

By agreeing with this form, you consent to the collection, use and/or disclosure of your child’s personal information as described herein and in justmine’s Privacy Policy regarding to the miinhealth platform https://www.miinehealth.com/privacy-policy. We may disclose your child’s personal information to the camp or school for which this consent is being requested. Your permission is required for the collection, use, or disclosure of your child's personal information. We will not activate your child's account for collection and transmission of personal information you provide us permission.

 

By providing the information and signing this consent form, you certify that you have been provided with access to copies of, and have reviewed and fully understand justmine Inc.’s Privacy Policy https://www.miinehealth.com/privacy-policy and Terms of Use https://www.miinehealth.com/terms-conditions, related to the miinehealth platform, that you agree on behalf of your child to such Terms of Use and that the information included in this consent form is true under penalty of perjury.

 

You may revoke your consent at any time to refuse further collection and use of your child’s information. If you desire to revoke this consent, please revoke your consent in your app account, under My Care > Profile Settings > Legal & Consent.

 

If you revoke your consent your child will no longer be able to use the services and functionality available at and through the Website of the App.