Last modified: August, 2020
Occom Medical Weight Loss d/b/a Form Health, Inc. (“Form Health,” “we,” “our,” or “us”) respects your privacy, and we are committed to protecting it through our compliance with this policy.
This policy applies to information we collect:
- on our Website and Application;
- in email, text, and other electronic messages between you and our Website and Application;
- when you interact with our advertising and applications on third party websites and services, if those applications or advertising include links to this policy.
It does not apply to information collected by:
- us offline or through any other means, including on any other website operated by Form Health or any third party;
- any third party, including through any application or content (including advertising) that may link to or be accessible from or on the Website or Application.
Note, Form Health is not a medical group. Any telemedicine consults obtained through our Website or Application are provided by independent medical practitioners including, but not limited to, Form Health Associates (MA), P.C. and Form Health Associates, P.C. (collectively, “Form Health Medical”), independent medical groups with a network of United States based health care providers (each, a “Provider”). Form Health Medical (or your own medical provider if you do not use a Form Health Medical Provider) is responsible for providing you with a Notice of Privacy Practices describing its collection and use of your health information, not Form Health. If you do not agree to be bound by those terms, you are not authorized to access or use our Website and Application, and you must promptly exit our Website and Application.
2. Children Under the Age of 18
Our Website and Application are not intended for children under the age of 18 and children under the age of 18 are not permitted to use our Website or our Application. We will remove any information about a child under the age of 18 if we become aware of it.
Our Website and Application are not intended for children under 18 years of age. No one under age 18 may provide any information to or through the Website or Application. We do not knowingly collect Personal Data from children under 18. If you are under 18, do not use or provide any information on our Website or in our Applications or on or through any of their features, including your name, address, telephone number, email address, or any screen name or user name you may use. If we learn we have collected or received Personal Data from a child under 18 without verification of parental consent, we will delete that information. If you believe we might have any information from a child under 18, please contact us at or call us at (617)-505-1520.
3. Information We Collect About You and How We Collect It
We collect different types of information about you, including information that may directly identify you, information that is about you but individually does not personally identify you, and information that we combine with our other users. This includes information that we collect directly from you or through automated collection technologies.
We collect several types of information from and about users of our Website and Application, specifically information:
- by which you may be personally identified, such as name, address, e-mail address, telephone numbers, driver’s license number (or other government identification number), date of birth, credit or debit card number (for payment purposes only), images, photos, and video of you, your medical history, your race or ethnicity, and health information (“Personal Data”);
- that is about you but individually does not identify you, such as traffic data, logs, referring/exit pages, date and time of your visit to our Website or use of our Application, error information, clickstream data, and other communication data and the resources that you access and use on the Website or through our Application; or
- about your Internet connection, the equipment you use to access our Website or use our Application and usage details.
We collect this information:
- directly from you when you provide it to us;
- automatically as you navigate through the Website or use our Application. Information collected automatically may include usage details, IP addresses, and information collected through cookies and other tracking technologies; and
- From third parties, for example, our business partners.
Information You Provide to Us
The information we collect on or through our Website or through our Application is:
- information that you provide by filling in forms on our Website or the Application. This includes information provided at the time of registering to use our Website or Application, using our Provider consultation services, purchasing products, or requesting further services. We may also ask you for information when you report a problem with our Website or Application;
- records and copies of your correspondence (including email addresses), if you contact us; and
- details of transactions you carry out through our Website or through the Application and of the fulfillment of your orders. You may be required to provide financial information before placing an order through our Website or Application.
You also may provide information to be published or displayed (hereinafter, “posted”) on public areas of the Website or Application or transmitted to other users of the Website or Application or third parties (collectively, “User Contributions”). Your User Contributions are posted on and transmitted to others at your own risk. Although we limit access to certain pages, please be aware that no security measures are perfect or impenetrable. Additionally, we cannot control the actions of other users of the Website and Application with whom you may choose to share your User Contributions. Therefore, we cannot and do not guarantee that your User Contributions will not be viewed by unauthorized persons.
Information We Collect Through Automatic Data Collection Technologies
As you navigate through and interact with our Website and Application, we may use automatic data collection technologies to collect certain information about your equipment, browsing actions, and patterns, specifically:
- details of your visits to our Website or Application, such as traffic data, location, logs, referring/exit pages, date and time of your visit to our Website or use of our Application, error information, clickstream data, and other communication data and the resources that you access and use on the Website or in the Application;
- metadata and other information associated with other files stored on your device, this may include, photographs, audio and video clips, personal contacts, and address book information; and
- information about your computer, mobile device, and Internet connection, specifically your IP address, operating system, browser type, and Application version information.
The information we collect automatically may include Personal Data or we may maintain it or associate it with Personal Data we collect in other ways or receive from third parties. It helps us to improve our Website and Application and to deliver a better and more personalized service by enabling us to:
- estimate our audience size and usage patterns;
- store information about your preferences, allowing us to customize our Website and our Application according to your individual interests;
- recognize you when you return to our Website and our Application.
The technologies we use for this automatic data collection may include:
4. How We Use Your Information
We use your Personal Data for various purposes described below, including to:
- provide our Website or Application to you;
- provide products and services to you;
- provide you with information you request from us;
- enforce our rights arising from contracts;
- notify you about changes; and
- provide you with notices about your account.
We use information that we collect about you or that you provide to us, including any Personal Data:
- to present our Website and its contents to you;
- to present our Application;
- to provide our products and services to you;
- to provide you with information, products, or services that you request from us or that may be of interest to you;
- to process, fulfill, support, and administer transactions and orders for products and services ordered by you;
- to provide you with notices about your Form Health account;
- to contact you in response to a request;
- to fulfill any other purpose for which you provide it;
- to administer surveys and request feedback;
- to carry out our obligations and enforce our rights arising from any contracts entered into between you and us, including for billing and collection;
- to notify you about changes to our Website, our Application, or any products or services we offer or provide though them;
- in any other way we may describe when you provide the information; and
- for any other purpose with your consent.
We may also use your information to contact you about goods and services that may be of interest to you, including through newsletters. If you wish to opt-out of receiving such communications, you may do so at any time by clicking unsubscribe at the bottom of these communications or by visiting your Account Preferences page. For more information, see Choices About How We Use and Disclose Your Information.
5. Disclosure of Your Information
- our affiliates and third party service providers that we use to support our business;
- to a company we merge, acquire, or that buys us, or in the event of change in structure of our company of any form;
- to comply with our legal obligations;
- to affiliates and third parties for their own commercial purposes;
- to enforce our rights; and
- with your consent.
- to contractors, service providers, and other third parties we use to support our business. The services provided by these organizations include providing IT and infrastructure support services, and ordering, order fulfillment, marketing, and payment processing services;
- to a buyer or other successor in the event of a merger, divestiture, restructuring, reorganization, dissolution, or other sale or transfer of some or all of our assets, whether as a going concern or as part of bankruptcy, liquidation, or similar proceeding, in which Personal Data held by Form Health about our Website and Application users are among the assets transferred;
- to fulfill the purpose for which you provide it. For example, we may disclose your personal information to a Provider or a pharmacy made available through our Website or Application;
- for any other purpose disclosed by us when you provide the information;
- with your consent.
We may also disclose your Personal Data:
- to comply with any court order, law, or legal process, including to respond to any government or regulatory request;
- if we believe disclosure is necessary or appropriate to protect the rights, property, or safety of Form Health, our customers, or others. This includes exchanging information with other companies and organizations for the purposes of fraud protection and credit risk reduction.
6. Choices About How We Use and Disclose Your Information
We offer you choices on how you can opt out of our use of tracking technology, disclosure of your Personal Data for our advertising to you, and other targeted advertising.
We do not control the collection and use of your information collected by third parties described above in Disclosure of Your Information. These third parties may aggregate the information they collect with information from their other customers for their own purposes.
In addition, we strive to provide you with choices regarding the Personal Data you provide to us. We have created mechanisms to provide you with control over your Personal Data:
- Promotional Offers from Form Health. If you do not wish to have your email address used by Form Health to promote our own products and services, you can opt-out at any time by clicking the unsubscribe link at the bottom of any email or other marketing communications you receive from us or by using the Contact Information set forth below. This opt out does not apply to information provided to Form Health as a result of a product purchase, or your use of our services.
- Targeted Advertising. To learn more about interest-based advertisements and your opt-out rights and options, visit the Digital Advertising Alliance and the Network Advertising Initiative websites ( and ). Please note that if you choose to opt out, you will continue to see ads, but they will not be based on your online activity. We do not control third parties’ collection or use of your information to serve interest-based advertising. However, these third parties may provide you with ways to choose not to have your information collected or used in this way. You can also opt out of receiving targeted ads from members of the NAI on its website.
7. Your Rights Regarding Your Information and Accessing and Correcting Your Information
You may review and change your personal information by logging into the Application or Website and visiting your Account Preferences page.
You can review and change your Personal Data by contacting us using the Contact Information set forth below. You may also notify us through the Contact Information below of any changes or errors in any Personal Data we have about you to ensure that it is complete, accurate, and as current as possible or to delete your account. We cannot delete your personal information except by also deleting your account with us. We may also not be able to accommodate your request if we believe it would violate any law or legal requirement or cause the information to be incorrect.
8. Do Not Track Signals
We may use automated data collection technologies to track you across websites. We currently do not honor do-not-track signals that may be sent by some browsers.
We also may use automated data collection technologies to collect information about your online activities over time and across third-party websites or other online services (behavioral tracking). Some web browsers permit you to broadcast a signal to websites and online services indicating a preference that they “do not track” your online activities. At this time, we do not honor such signals, and we do not modify what information we collect or how we use that information based upon whether such a signal is broadcast or received by us.
9. Data Security
Information transmitted over the Internet is not completely secure, but we do our best to protect your Personal Data. You can help protect your Personal Data and other information by keeping your password to our Website confidential.
We have implemented measures designed to secure your Personal Data from accidental loss and from unauthorized access, use, alteration, and disclosure. We use encryption technology for information sent and received by us.
The safety and security of your information also depends on you. Where you have chosen a password for the use of our Website or Application, you are responsible for keeping this password confidential. We ask you not to share your password with anyone.
Unfortunately, the transmission of information via the Internet is not completely secure. Although we do our best to protect your Personal Data, we cannot guarantee the security of your Personal Data transmitted to our Website or on or through our Application. Any transmission of Personal Data is at your own risk. We are not responsible for circumvention of any privacy settings or security measures contained on the Website, in your operating system, or in the Application.
11. Contact Information
You may contact us through the contact information below.
How to Contact Us:
Form Health, Inc.
Attn: Privacy Officer
179 Lincoln St, Suite 404
Boston, MA 02111