THIS FORM IS FOR BUSINESS INQUIRIES ONLY, NOT FOR SUPPORT SERVICE INQUIRIES. DO NOT INCLUDE PROTECTED HEALTH INFORMATION IN THIS FORM. Call your independently owned and operated Peercovery® location for all support service matters. If you include personal, protected health information in any email or other communication to us that is protected by federal, state or local privacy laws, including without limitation the Health Insurance Portability Act (HIPAA) or similar laws or regulations, you hereby irrevocably consent to your transmission and disclosure, and our receipt, possession and subsequent transmission and disclosure, of said protected personal health information, including ongoing or subsequent transmission, receipt and possession by third party email systems, website hosting, cloud/internet storage and backup providers, internet providers and all other related or third parties of any kind. You further hereby agree and acknowledge that we and all such third parties cannot guarantee the security or confidentiality of such protected health information and, further, that we each specifically requested that you not provide any protected health information to us, and that we do not consent, implicitly or explicitly, to your transmission, communication or disclosure to us of any form of confidential or protected health information for any purpose whatsoever and are under no duty to you or any person or entity to protect the confidentiality of such information. 

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Disclaimer: This website and the information on this website are not intended as an offer to sell or the solicitation of an offer to buy a franchise. We offer franchises solely by means of our Franchise Disclosure Document. The U.S. Federal Trade Commission and certain states have laws that govern the offer and sale of franchises. We will not offer you a franchise unless and until we have complied with all applicable legal requirements in your jurisdiction. Certain states require that we register the Franchise Disclosure Document in those states. The communications on this web site are not directed by us to the residents of any of those states. Moreover, we will not offer or sell franchises in those states until we have registered the franchise (or obtained an applicable exemption from registration) and delivered the Franchise Disclosure Document to the prospective franchisee in compliance with applicable law. 

 

Peercovery® is a network of independently owned and operated peer support service agencies. PeerCare LLC is not a provider of peer support or other forms of healthcare services.