Fawkes Biodata – HIPAA Authorization and Data Use Waiver for Beta Testers
Effective Date: July 2025
Fawkes Biodata, Inc. (“Fawkes”, “we”, “our”, or “us”) is building a platform that empowers individuals to aggregate, manage, and use their personal health data for clinical trial matching and other health-related purposes. As a beta tester, your participation helps us improve the platform before its public release.
This waiver authorizes us to collect, use, and share your health information in a controlled, pre-release environment. It also includes important disclosures about privacy protections and limitations during development.
1. Authorization to Use and Disclose Health Information
You authorize Fawkes Biodata to access, use, and disclose your personal health information (PHI), including:
- Electronic health records (EHRs) from your doctors, hospitals, pharmacies, labs, insurers, and other healthcare providers;
- Medical and claims history;
- Diagnoses, treatments, prescriptions, imaging, lab results, and other clinical data.
This information may be collected through direct uploads, health information networks, patient portals, or authorized third-party data providers.
2. Purpose of Use
Your PHI will be used solely for:
- Testing and validating the Fawkes platform in a beta development environment;
- Evaluating data aggregation, record summarization, and trial-matching features;
- Improving system performance, accuracy, and user experience;
- Conducting internal research and product development.
Your data will not be sold or shared for advertising or commercial resale.
3. Notice of Limited HIPAA Coverage During Beta Testing
While we are committed to high standards of privacy and security, you acknowledge and accept that not all services or systems involved in the Beta Program are covered by HIPAA-compliant agreements at this time.
This is not due to technical deficiencies, but because certain third-party tools and services we are testing do not yet have formal HIPAA Business Associate Agreements (BAAs) in place. These third parties may include infrastructure providers, data processing tools, and AI platforms under evaluation.
Fawkes is working to secure HIPAA-compliant arrangements as we move toward full production. In the interim, we maintain strong internal security controls and limit access to your information to authorized personnel only.
4. Voluntary Participation and Revocation Rights
Your participation in the Beta Program is entirely voluntary. You may revoke this authorization at any time by contacting us at:
receipts@fawkesbiodata.io
Your revocation will not affect any use or disclosure made before your request is processed.
5. Expiration of Authorization
Unless revoked earlier, this authorization will expire one year from the date of signing or upon completion of the Beta Program, whichever is sooner.
6. Your Rights and AcknowledgmentsBy signing this form, you acknowledge:
- You understand this is a pre-release beta test of a health data platform;
- You understand that some third-party systems used during beta testing may not be covered by HIPAA, but are nonetheless secured to the best of our ability;
- You voluntarily authorize the use and sharing of your PHI for testing and development purposes;
- You may withdraw at any time;You will receive a copy of this authorization for your records.