Terms of Service for Non-Occupational Health Audiological Services
Last Revised: August 2025
These Terms of Service for Audiological Services (“AUD Terms”) form a legal agreement between the customer identified in a SHOEBOX PureTest quote that includes non-occupational health-based Audiological Services (“Customer”) and WS Audiology Canada Inc., doing business as “Shoebox” (“SHOEBOX”).
PureTest is classified as a Type 4 audiometer under ANSI/ASA S3.6 (2018), which is categorized for screening and monitoring purposes. It is approved for use in all 50 states. In the workflow agreed upon with customer, automated results provided following each test are not intended for diagnostic use. Interpretation and clinical decisions remain the responsibility of the referring provider. Threshold shift interpretation must be conducted by licensed professionals, which can be facilitated through the SHOEBOX Audiological Review process.
These AUD Terms are effective as of the date of Customer’s signature on the quote or effective date on the customer’s agreement and will continue until the provision of Services is concluded. Collectively, the audiological services outlined in the quote are referred to as “Services” in these AUD Terms.
1. AUDIOLOGICAL SERVICES
1) Audiology Review Services:
a) Provided that an authorized signing officer of Customer has signed the SHOEBOX Data Access Form, the SHOEBOX Audiological Review Team (the “Team”) will remotely review and assess audiograms generated by the Customer using SHOEBOX PureTest and backing such data up in the SHOEBOX Data Management Portal (“Portal”). The Team will use the applicable review criteria in its assessment in accordance with the American Speech, Language and Hearing Association (“ASHA”) shift criteria.
b) SHOEBOX will perform Audiology Review Services for up to the number of patients and for the states/jurisdictions identified on the quote as submitted for request. All review requests should be submitted through audiologyreview@shoebox.md including referral number, state, time of test, and patient initials. SHOEBOX is not responsible for any damages, delays or misreporting due to the Customer not performing or submitting a review request. SHOEBOX is not responsible or liable for any complications or damages related in any way to inaccuracies in baselines generated from data received by SHOEBOX from Customer or third-party sources.
c) The Team will assess all requested audiograms for non-ototoxicity related hearing loss indications. If applicable, member of the Team will provide a statement that reclassifies shifts when warranted and therefore deemed non-drug-related.
Alternatively, if a shift is deemed ototoxicity -related, at least in part, a statement will be entered to reflect that confirmation. Note: Clinical determinations from the Team are final. Customer may seek external relatedness determination(s) at their discretion and cost.
Reviews will be conducted and interpretations provided within 8 business days of submission. Reviews will be submitted through the portal and in response to requestor unless alternative communication paths are agreed upon by both parties in advance.
d) Audiological Review Services include up to 2 hours of audiological consultation to address questions regarding specific cases per year. Customer shall send an email to audiologyreview@shoebox.md to request assistance and the Team shall respond within 2 business days after receipt of the email.
2) Audiology Consulting Services:
Customer may also request a quote for Audiology Consulting Services, which may include:
Providing contact information for a local audiologist to whom Customer can refer tested individuals requiring a more comprehensive assessment; Answering questions about testing scenarios, complex individual cases, etc; Additional custom reporting requests; or, Other Services as agreed by the parties.
2. CUSTOMER RESPONSIBILITIES
Customer is responsible and accountable for:
1) Customer is wholly responsible for the accuracy, completeness, and quality of historical audiograms, marked baselines, and individual data uploaded into the Portal.
2) Ensuring that testing has been completed in an environment compliant with regulatory ambient noise levels.
3) Providing a copy of the hearing test results to tested individual and referring physician when requested, whether or not a shift in hearing has been identified.
4) This may include inquiries into particular test systems, or testing environments that require additional attention.
5) Exporting reports to referring physician, providing instructions to physician for submitting review requests, and following-up on SHOEBOX recommendations.
6) Manually entering all hearing testing data that is obtained outside of SHOEBOX testing into Portal (e.g. external clinics from referrals).
7) Configuring and adhering to Portal settings per the Team’s recommendations. Customer will configure the Portal Data Management rules for auto-triage as
recommended by the Team and agrees that Customer will not change the configuration in the Portal without reviewing it with Team. SHOEBOX shall not be responsible or liable for any missed reviews due to misconfiguration or changes by Customer or any 3rd party performing services for the Customer.
8) It is imperative that the Team be aware of ALL of the states that individuals are being tested in as Audiological licensure is state-based and each state has specific SHOEBOX Audiology Reviewers assigned to it. As such, Customer will notify SHOEBOX at least 30 days in advance of any significant increase (>50) in the number of tested individuals or of any change to the specific states in which Services are to be conducted.
3. BILLING AND PAYMENT
1) SHOEBOX will perform the Services set out in the quote and Customer will make payment to SHOEBOX on the terms set out in the applicable invoice. In the event that the scope of Services changes from what is detailed in the quote, including but not limited to changes to the number of tested individuals or the states requiring coverage, the parties agree to sign a new quote to reflect such changes as needed.
4. TERM, TERMINATION AND MODIFICATION OF AUD TERMS
1) The subscription to the Services will start on the date that the invoice for the Services is issued (“Subscription Start Date”), however the Team is responsible only for the audiograms submitted for review. The Services shall auto-renew for successive one (1) year terms on the anniversary of the Subscription Start Date unless one party delivers thirty (30) days’ prior written notice of non-renewal to the other party.
2) Either party may terminate these AUD Terms: (i) for material failure by the other party to comply with the terms of these AUD Terms (provided such breach is not cured within 30 days after written notice of the breach is received from the other party); or (ii) immediately in the event the other party seeks the protection of any bankruptcy court, becomes insolvent, or makes an assignment for the benefit of creditors. In the event of such termination, Customer shall immediately pay to SHOEBOX all amounts due for Services performed as of the date of termination.
3) SHOEBOX reserves the right, in its sole discretion, to modify, discontinue or terminate any part of the Services or modify these AUD Terms at any time by posting the revised terms at www.shoebox.md or sending to Customer in email and they will be effective as of the Last Revised date.
4) The number of agreed-upon reviews per year is subject to change based on the terms outlined in the annual renewal quote.