Terms of Service

The Service is intended for use by licensed healthcare professionals, their staff, and authorized healthcare organizations. By creating an account, you represent that you are at least 18 years old and authorized to use clinical software in your jurisdiction. You are responsible for keeping your credentials confidential and for all activity under your account.

attest provides informational clinical decision support and documentation assistance for licensed clinicians. It generates drafts, summaries, citations, and other reasoning aids to assist qualified professionals. attest does not practice medicine, is not a substitute for professional clinical judgment, and is not intended for diagnosis or treatment without independent review by a licensed clinician. The Service does not:

• Diagnose, treat, cure, or prevent any disease.
• Replace the judgment of a licensed clinician.
• Constitute medical advice or a doctor-patient relationship.
• Function as an FDA-cleared medical device (unless explicitly designated for a specific feature, in writing).

Not for emergencies. The Service is not designed or intended for emergency, urgent, or other time-critical decisions. If you believe there may be a medical emergency, rely on your clinical judgment and established emergency protocols, not on the Service.

Clinician responsibility.The clinician is solely responsible for all clinical decisions and for the care of their patients, and for independently verifying every AI-generated output against primary sources, including citations, dosages, contraindications, and other clinical claims. Every output must be reviewed and approved by a qualified clinician before it is used in a patient's care, signed into the medical record, or otherwise relied upon.

Assumption of risk.You acknowledge that AI-generated output may be incomplete, inaccurate, or otherwise incorrect, and you assume the risk of any reliance on it. The Service supports, and does not replace, the clinician's independent professional judgment.

The Service is intended for de-identified, synthetic, or hypothetical data and does not process PHI by default. Entering PHI is not part of the standard Service and requires a separate signed Business Associate Agreement (“BAA”) executed before any PHI is entered. Where a BAA is in effect, it controls our obligations with respect to PHI; in case of conflict between these Terms and the BAA, the BAA controls for PHI matters.

• You represent and warrant that any PHI you enter has been collected lawfully and that you have the right to disclose it to us for the purposes of the Service.
• You will not enter PHI in trial, free, or demo deployments where a BAA is not in effect.
• You will use the Service's access controls (role assignments, MFA, audit log review) to limit PHI access within your organization to the minimum necessary.

De-identification. You are responsible for de-identifying your inputs and for minimizing identifiers to the minimum necessary. Unless an executed BAA is in effect, you must not enter PHI or direct patient identifiers (such as names, dates, contact details, or record numbers) into the Service, and you are responsible for removing them from your inputs before submission.

You will not, and will not allow anyone using your account to:

• Use the Service to provide medical care without independent clinician review.
• Reverse engineer, decompile, or attempt to extract proprietary systems or prompts.
• Use outputs to train competing systems or to evaluate the Service against a competitor without our written consent.
• Upload malware, scrape the Service, or interfere with other customers' use.
• Attempt to re-identify de-identified data or circumvent access controls.
• Use the Service for any unlawful purpose or to facilitate misconduct.

Paid plans renew automatically at the end of each billing period unless cancelled. Fees are non-refundable except as required by law or your Order Form. We may change pricing on renewal with at least thirty (30) days' notice. Taxes are your responsibility unless we are required to collect them.

You retain all rights to the clinical content, notes, recordings, and documents you submit (“Customer Content”). You grant attest a worldwide, royalty-free license to host, process, and transmit Customer Content solely as needed to provide the Service and as governed by the BAA for any PHI. We will not use Customer Content to train general-purpose systems.

The Service, including the software, models, prompts, designs, and documentation, is owned by attest and licensed, not sold. Feedback you provide may be used by us without obligation. Outputs generated by the Service in response to your prompts are licensed to you for your internal clinical use, subject to these Terms and any applicable BAA.

The Service relies on operational systems for hosting, email, billing, security, and support. We remain responsible to you for the Service in accordance with these Terms and the BAA.

Each party will protect the other's Confidential Information with at least the same care it uses for its own confidential information, and at least reasonable care. Confidential Information does not include information that is public, independently developed, or rightfully obtained from a third party.

We warrant that we will provide the Service with commercially reasonable care and skill, and that the Service will materially conform to its documentation. EXCEPT FOR THE EXPRESS WARRANTIES IN THESE TERMS, THE SERVICE IS PROVIDED “AS IS,” WITHOUT WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT. WE DO NOT WARRANT THAT AI OUTPUTS ARE ACCURATE, COMPLETE, RELIABLE, OR FIT OR SUITABLE FOR ANY CLINICAL USE, AND THE SERVICE IS NOT A SUBSTITUTE FOR INDEPENDENT CLINICAL JUDGMENT.

TO THE MAXIMUM EXTENT PERMITTED BY LAW, NEITHER PARTY WILL BE LIABLE FOR INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, OR FOR LOST PROFITS OR REVENUE. TO THE MAXIMUM EXTENT PERMITTED BY LAW, CARDINAL VECTOR LLC WILL NOT BE LIABLE FOR ANY CLINICAL OUTCOME, PATIENT HARM, OR DECISION MADE OR NOT MADE IN RELIANCE ON THE SERVICE OR ITS OUTPUTS. EACH PARTY'S AGGREGATE LIABILITY FOR ALL CLAIMS ARISING OUT OF OR RELATED TO THESE TERMS WILL NOT EXCEED THE GREATER OF (A) THE FEES PAID OR PAYABLE BY YOU IN THE TWELVE (12) MONTHS PRECEDING THE CLAIM OR (B) ONE HUNDRED U.S. DOLLARS (USD 100). These limits do not apply to a party's indemnification obligations, breach of confidentiality, or amounts owed under the BAA for breach notification and remediation.

We will defend you against any third-party claim that the Service, as provided by us and used in accordance with these Terms, infringes that third party's intellectual property rights, and we will pay damages finally awarded by a court of competent jurisdiction.

You will defend Cardinal Vector LLC against any third-party claim arising from (a) your Customer Content, (b) your use of the Service in violation of these Terms or applicable law, (c) clinical decisions made using the Service, (d) your representations to patients or third parties, and (e) your entry of PHI or patient identifiers into the Service in violation of these Terms, and you will indemnify Cardinal Vector LLC for damages and reasonable costs finally awarded or agreed in settlement for such claims.

These Terms remain in effect until your account is closed or your subscription ends. Either party may terminate for material breach if not cured within thirty (30) days of written notice. On termination, you may export your Customer Content for thirty (30) days; afterwards we delete or de-identify it per our Privacy Policy. Sections of these Terms that by their nature should survive termination (e.g., warranties, liability limits, indemnification, governing law) will survive.

You will comply with all applicable laws including HIPAA, state medical practice acts, controlled substance regulations, and export controls. We will comply with applicable laws in providing the Service.

These Terms are governed by the laws of the State of Delaware, without regard to conflict-of-laws principles. The parties consent to exclusive jurisdiction and venue in the state and federal courts located in Wilmington, Delaware. Each party waives the right to a jury trial.

We will notify customers in writing of material changes at least thirty (30) days before they take effect. For individual users, we will post changes here with an updated effective date. Continued use after the effective date constitutes acceptance.

• Legal, BAA, and general inquiries: contact@attest.health