Terms and Conditions of Use

Effective Date: 02-14-2026 | Last Revised: 02-14-2026

PLEASE READ THESE TERMS AND CONDITIONS OF USE (THE "TERMS") CAREFULLY BEFORE ACCESSING OR USING ANY WEBSITE, APPLICATION, PLATFORM, OR SERVICE OPERATED BY OR ON BEHALF OF Altera Health P.C., A WYOMING PROFESSIONAL CORPORATION, OPERATING A NETWORK OF LOCALLY BRANDED PSYCHIATRIC PRACTICES UNDER THE Top Tier Psychiatry NAME (COLLECTIVELY, "Top Tier Psychiatry," "COMPANY," "WE," "OUR," OR "US"). THESE TERMS CONSTITUTE A LEGALLY BINDING AGREEMENT BETWEEN YOU ("USER," "YOU," OR "YOUR") AND Top Tier Psychiatry.

BY ACCESSING, BROWSING, OR USING THE SERVICES IN ANY MANNER, YOU EXPRESSLY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREE TO BE BOUND BY THESE TERMS IN THEIR ENTIRETY. IF YOU DO NOT AGREE TO ANY PROVISION OF THESE TERMS, YOU MUST IMMEDIATELY CEASE ALL USE OF THE SERVICES.

1. Definitions

"Services" means all websites, web applications, mobile applications, scheduling platforms, intake systems, communication channels, clinical services, and any other digital or physical services operated by or on behalf of Top Tier Psychiatry and its locally branded practices. "Content" means all text, graphics, images, logos, trademarks, audio, video, software, code, data, and other materials displayed on or made available through the Services. "User Content" means any information, data, text, or materials submitted by you through the Services.

2. About Top Tier Psychiatry

Top Tier Psychiatry is the network name of Altera Health P.C., a Wyoming professional corporation that operates a network of locally branded psychiatric practices across multiple states. Each local brand operates under its own trade name but is part of Altera Health P.C.. References to "Top Tier Psychiatry" in these Terms include all such locally branded practices.

3. Acceptance and Modifications

We reserve the right to modify these Terms at any time by posting the revised Terms with an updated "Last Revised" date. Your continued use of the Services constitutes acceptance of modified Terms.

4. Nature of Services; No Provider-Patient Relationship

THE CONTENT PROVIDED THROUGH THE SERVICES IS FOR INFORMATIONAL PURPOSES ONLY AND DOES NOT CONSTITUTE MEDICAL ADVICE, PSYCHIATRIC ADVICE, DIAGNOSIS, TREATMENT, OR A RECOMMENDATION. Accessing the Services or submitting a contact form does not establish a provider-patient relationship. Such a relationship is formed exclusively through the formal clinical intake process.

IF YOU ARE EXPERIENCING A MEDICAL OR PSYCHIATRIC EMERGENCY, IMMEDIATELY CALL 911 OR PROCEED TO YOUR NEAREST EMERGENCY DEPARTMENT.

APPOINTMENT-ONLY POLICY: All clinical services are delivered exclusively by appointment. No walk-in services are available.

5. Eligibility

The Services are intended for individuals at least eighteen (18) years of age. Top Tier Psychiatry provides clinical services to patients aged six (6) and older; for patients under eighteen (18), a parent or legal guardian must consent to treatment and agree to these Terms on behalf of the minor.

6. Telehealth Services Disclosure

Top Tier Psychiatry delivers psychiatric services primarily through secure audio and video telecommunications technology. By scheduling an appointment, you acknowledge: (a) telehealth involves electronic communications between you and your provider; (b) telehealth has limitations compared to in-person visits; (c) you are responsible for having appropriate technology; (d) providers are licensed in your state; (e) providers may prescribe medications including controlled substances; (f) technology tools may be used for clinical documentation; (g) clinical services are subject to the limitations described below; (h) you have the right to refuse telehealth; (i) telehealth is not for emergencies. You will sign a detailed Telehealth Informed Consent before your first appointment.

(g) Clinical Limitations. Top Tier Psychiatry does not guarantee that any visit will result in a diagnosis. Visits are clinical assessments that may or may not lead to a diagnosis. Top Tier Psychiatry does not guarantee that medication will be prescribed; prescribing decisions are based on clinical assessment, diagnoses, and the provider's medical judgment. If medication is prescribed, Top Tier Psychiatry does not guarantee that the medication will be available at your pharmacy or covered by your insurance plan, and cannot guarantee the cost of any medication. If medication is prescribed, it is your responsibility to follow up with your pharmacy to ensure the prescription is processed. Top Tier Psychiatry is not responsible for contacting the pharmacy on your behalf. If you have confirmed with your pharmacy that an issue remains, contact Top Tier Psychiatry for assistance.

7. Payment, Billing, Cancellation, and No-Show Policy

(a) We accept various insurance plans and self-pay options. (b) You are responsible for copayments, coinsurance, deductibles, and amounts not covered by insurance. (c) Failure to provide adequate cancellation notice or failure to appear may result in a fee. (d) Payments are processed through Stripe. (e) Outstanding balances may be referred to collections. (f) Fees for completed services are generally non-refundable. (g) For patients under eighteen (18) years of age, the parent or legal guardian is financially responsible for all fees, charges, copayments, deductibles, no-show fees, and late cancellation fees. Billing and financial notifications are sent to the parent or legal guardian. Appointment reminders and scheduling notifications are sent to both the parent or legal guardian and the minor patient where separate contact information is on file.

8. Privacy

Your use of the Services is governed by our Privacy Policy and Notice of Privacy Practices (HIPAA), both incorporated by reference.

9. Intellectual Property Rights

All Content is the exclusive property of Top Tier Psychiatry or its licensors. You are granted a limited, revocable, non-exclusive license to access the Content for personal, non-commercial use. Unauthorized reproduction is prohibited.

10. Prohibited Conduct

You agree not to: violate any law; infringe intellectual property rights; upload malware; attempt unauthorized access; interfere with the Services; scrape data; impersonate others; or transmit spam.

11. Third-Party Links

Links to third-party services are provided as a convenience and do not constitute endorsement. We are not responsible for third-party content or practices.

12. SMS/MMS Communications

If you opt in to SMS, you consent to receive autodialed or automated messages. Reply STOP to opt out. Message and data rates may apply. Consent is not required for services. You agree to notify us promptly of phone number changes.

13. Disclaimers of Warranties

THE SERVICES ARE PROVIDED "AS IS" AND "AS AVAILABLE" WITHOUT WARRANTIES OF ANY KIND. This disclaimer applies to the website and digital services only and does not disclaim warranties related to clinical care.

14. Limitation of Liability

IN NO EVENT SHALL Top Tier Psychiatry BE LIABLE FOR INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES. TOTAL AGGREGATE LIABILITY SHALL NOT EXCEED ONE HUNDRED DOLLARS ($100.00). This does not limit liability for clinical malpractice or professional negligence.

15. Indemnification

You agree to indemnify and hold harmless Top Tier Psychiatry from claims arising from your use of the Services, violation of these Terms, or violation of third-party rights.

16. Dispute Resolution and Binding Arbitration

DISPUTES (EXCLUDING CLINICAL MALPRACTICE) SHALL BE RESOLVED THROUGH BINDING INDIVIDUAL ARBITRATION ADMINISTERED BY THE AAA IN LARAMIE COUNTY, WYOMING. YOU WAIVE THE RIGHT TO A JURY TRIAL AND CLASS ACTION PARTICIPATION. Either party may seek injunctive relief for intellectual property or confidentiality matters.

17. Governing Law

These Terms are governed by Wyoming law. For matters not subject to arbitration, you consent to exclusive jurisdiction in Laramie County, Wyoming.

18. Termination

We may suspend or terminate your access to the Services at any time for violation of these Terms or other reasons. Termination does not affect the provider-patient relationship.

19. Severability

If any provision of these Terms is held to be invalid, illegal, or unenforceable by a court or arbitrator of competent jurisdiction, such provision shall be modified to the minimum extent necessary to make it valid, legal, and enforceable, or if modification is not possible, shall be severed from these Terms, and the remaining provisions shall continue in full force and effect.

20. Waiver

The failure of Top Tier Psychiatry to exercise or enforce any right or provision of these Terms shall not constitute a waiver of such right or provision. No waiver shall be effective unless made in writing and signed by an authorized representative of Top Tier Psychiatry.

21. Entire Agreement

These Terms, together with the Privacy Policy, Notice of Privacy Practices (HIPAA), Telehealth Informed Consent, Treatment Agreement, and any other policies, agreements, consents, or supplemental terms referenced herein or presented to you through the Services, constitute the entire agreement between you and Top Tier Psychiatry with respect to the subject matter hereof and supersede all prior or contemporaneous communications, proposals, negotiations, agreements, and understandings, whether written or oral, between you and Top Tier Psychiatry regarding such subject matter. No course of dealing, course of performance, or usage of trade shall be relevant to supplement, explain, or modify these Terms.

22. Force Majeure

Top Tier Psychiatry shall not be liable for any failure to perform, or delay in performance of, any obligation under these Terms where such failure or delay results from any cause beyond our reasonable control, including but not limited to: acts of God; natural disasters; epidemics, pandemics, or public health emergencies; war, terrorism, insurrection, or civil unrest; national or regional emergency; governmental actions, orders, restrictions, sanctions, or embargoes; cyber attacks, denial-of-service attacks, or other malicious electronic intrusions; utility, telecommunications, internet, or infrastructure failures; strikes, labor disputes, or work stoppages; supply chain disruptions; or any other event or circumstance of similar nature or effect.

23. Assignment and Delegation

You may not assign, transfer, delegate, sublicense, or otherwise dispose of any rights or obligations under these Terms, in whole or in part, whether by operation of law, merger, consolidation, change of control, or otherwise, without the prior written consent of Top Tier Psychiatry. Any purported assignment or transfer in violation of this provision shall be null, void, and of no force or effect. Top Tier Psychiatry may freely assign, transfer, or delegate its rights, obligations, and interests under these Terms to any successor-in-interest or acquirer of all or substantially all of Altera Health P.C.'s assets or business operations, without notice to or consent from you.

24. Notice Provisions

Any notice or communication required or permitted under these Terms shall be deemed effective when: (a) if to you, sent via email to the address associated with your account, posted on the Services, or delivered by any other means reasonably calculated to provide actual notice; or (b) if to Top Tier Psychiatry, sent via email to info@toptierpsych.com and confirmed received by an authorized representative. Notice sent by email shall be deemed given on the date of transmission, provided no delivery failure notification is received. Top Tier Psychiatry may, in its sole discretion, provide notice of material changes to these Terms through prominent display on the Services, push notification, or other electronic means.

25. Survival

Any provisions of these Terms that by their nature are intended to survive termination, expiration, or cancellation of your use of the Services shall survive and remain in full force and effect, including but not limited to provisions relating to: intellectual property ownership, indemnification, limitation of liability, disclaimers of warranties, dispute resolution and binding arbitration, governing law, confidentiality, data protection, and any other provisions which, by their express terms or by reasonable implication, are intended to survive.

26. No Third-Party Beneficiaries

These Terms are entered into solely between you and Top Tier Psychiatry. Nothing in these Terms shall be construed to create, confer, or grant any rights, benefits, claims, or causes of action to or upon any third party, whether express, implied, or incidental, except as may be expressly set forth herein or required by applicable law. Top Tier Psychiatry's officers, directors, employees, contractors, and agents are intended third-party beneficiaries of the indemnification, limitation of liability, and disclaimer provisions set forth herein.

27. Relationship of the Parties

Nothing in these Terms shall be construed to create a partnership, joint venture, employment, or agency relationship between you and Top Tier Psychiatry. Neither party has the authority to bind, commit, or make representations on behalf of the other party. The relationship between you and Top Tier Psychiatry is that of independent parties, and these Terms do not create any such relationship.

28. Compliance with Applicable Laws

You represent and warrant that your access to and use of the Services shall at all times comply with all applicable federal, state, local, and international laws, regulations, ordinances, rules, and orders, including but not limited to those governing healthcare privacy and security (HIPAA, HITECH), consumer protection, anti-spam communications (CAN-SPAM, TCPA), and any other applicable regulatory frameworks. You shall not use the Services in any jurisdiction where such use would be prohibited or restricted by applicable law.

29. Electronic Communications Consent

By accessing or using the Services, you consent to receive electronic communications from Top Tier Psychiatry, including but not limited to emails, SMS/MMS text messages (subject to your opt-in and the SMS Terms set forth herein), and other electronic messages. You agree that all agreements, notices, disclosures, and other communications that Top Tier Psychiatry provides to you electronically satisfy any legal requirement that such communications be in writing. Your consent to receive electronic communications does not affect your statutory rights.

30. Cumulative Remedies

All rights and remedies provided to Top Tier Psychiatry under these Terms are cumulative and not exclusive of any other rights or remedies that may be available at law, in equity, by statute, or otherwise. The exercise of any right or remedy by Top Tier Psychiatry shall not preclude the exercise of any other right or remedy.

31. Headings, Construction, and Interpretation

The headings, captions, and section titles used in these Terms are for convenience of reference only and shall not affect the meaning, interpretation, or construction of any provision herein. As used in these Terms: (a) "including" and similar terms mean "including without limitation"; (b) "or" is not exclusive; (c) words in the singular include the plural and vice versa; (d) "any" means "any and all"; (e) references to monetary amounts are in United States dollars unless otherwise specified; and (f) references to laws, regulations, or statutes include all amendments, successor legislation, and implementing regulations thereto.

32. Contact Information

Altera Health P.C., operating as Top Tier Psychiatry
Mailing Address: P.O. Box 8013, Greensboro, NC 27419
Email: info@toptierpsych.com
Phone: (725) 272-2411
Website: toptierpsych.com