ExamineeConsentandInformationSharing

You are an "Examinee" for purposes of this Examinee Consent if an Employer has directed you, through BlueHive, to complete an occupational health service such as an intake questionnaire, drug or alcohol test, physical examination, vaccination, vision or hearing test, or similar evaluation.

By accepting this Examinee Consent and using the Services, you authorize BlueHive and the Provider or Facility you select (or that is selected for you) to:

• Collect the information you provide through intake forms, questionnaires, and visits.
• Share that information with the requesting Employer to the extent necessary to confirm scheduling, completion, and the result the Employer is entitled to receive (for example, "fit for duty," "negative," or "passed") and to bill for the service.
• Share that information with the Provider or Facility delivering the service in order to perform it safely and accurately.
• Use the information for fraud prevention, quality assurance, audit, and legal compliance.

Detailed clinical findings (beyond the result the Employer is entitled to receive) remain with the Provider or Facility and are not shared with the Employer except as you separately authorize or as required by law.

The Provider or Facility is generally a HIPAA Covered Entity and will handle Protected Health Information (PHI) about you in accordance with HIPAA, its Notice of Privacy Practices, and applicable state law (including, where relevant, the California Confidentiality of Medical Information Act, the Texas Medical Records Privacy Act, and similar laws). BlueHive acts as a Business Associate to those Providers and Facilities and is bound by a separate Business Associate Agreement (BAA).

You may file a complaint with the Provider, with BlueHive's Privacy Officer through our contact form (subject: "HIPAA Complaint"), or with the U.S. Department of Health and Human Services Office for Civil Rights at https://www.hhs.gov/hipaa/filing-a-complaint.

If your Employer has directed you to complete a U.S. Department of Transportation ("DOT") examination — such as a DOT physical, FAA medical, or USCG merchant mariner examination — or a drug or alcohol test under DOT regulations (49 C.F.R. Part 40), additional federal rules apply. You acknowledge that: (a) the examining clinician will be a Certified Medical Examiner on the FMCSA National Registry (or, for non-FMCSA programs, holds the equivalent required certification); (b) examination results, certificates, and required identifying information will be transmitted to the FMCSA National Registry or the applicable agency as required by federal regulation; and (c) for DOT drug and alcohol testing, you must comply with strict chain-of-custody procedures, your specimen will be analyzed by an HHS-certified laboratory, and verified results will be reviewed by a Medical Review Officer (MRO) before release.

For OSHA medical surveillance examinations (including respirator clearance under 29 C.F.R. § 1910.134), you acknowledge that the examining clinician will provide your Employer only the written opinion the regulation requires (such as a fit-for-duty determination), and not the underlying medical findings.

The Genetic Information Nondiscrimination Act ("GINA," 42 U.S.C. § 2000ff) generally prohibits employers from requesting, requiring, or purchasing genetic information about you or your family members. You acknowledge that BlueHive and the Provider will not request your genetic information as part of an employer-directed occupational health service unless required by law for a specific, separately authorized purpose (for example, certain limited workplace genetic monitoring permitted under GINA). If you voluntarily disclose genetic information during a service, the Provider may, but is not required to, document that disclosure in the medical record without sharing it with your Employer.

Your acceptance of this Examinee Consent and your participation in the requested occupational health service are voluntary. You may decline at any time. However, declining may mean that you cannot complete the service your Employer has requested, which may affect your hiring, assignment, or continued employment to the extent permitted by law. BlueHive does not make those employment decisions; the Employer does.

You represent that the information you provide through the Services (including identity, contact details, medical history responses, and current medications) is true, accurate, and complete to the best of your knowledge. You agree to update information that becomes inaccurate during the course of the service.

You agree that BlueHive and, where applicable, the Provider may send you transactional and reminder communications by email and text message about your appointment, intake, results, and the status of your visit. Message and data rates may apply. You can opt out of text messages at any time by replying STOP, and you can request help by replying HELP. Opting out of transactional messages may affect your ability to complete the service.

BlueHive retains your information for the periods described in the Privacy Policy and as required by HIPAA, the executed BAA, and applicable federal and state law. The Provider or Facility retains your medical record according to its own records-retention policy and applicable law.

You have the right to access, correct, delete, and limit the use of your information as described in the Privacy Policy. To exercise those rights, use our contact form (subject: "Privacy Request"). Information held by the Provider or Facility (including your medical record) must generally be requested directly from that Provider or Facility.

You may withdraw this Examinee Consent at any time through our contact form (subject: "Withdraw Consent"). Withdrawal does not affect the lawfulness of any sharing that occurred before withdrawal. After withdrawal, BlueHive will stop sharing your information with the Employer except where retention or further sharing is required by law, by HIPAA, or to complete a service you have already requested.

This Examinee Consent is governed by the laws of the State of Delaware, without regard to its conflict-of-laws principles. This Examinee Consent does not modify any rights you have under HIPAA or applicable federal or state law.

Questions, concerns, or requests about this Examinee Consent can be directed to BlueHive's Privacy Officer through our contact form. Questions about the medical aspects of your visit should be directed to the Provider or Facility delivering the service.