a. The information provided in the application is true, complete and accurate;
b. The patient authorizes Strata (and/or third parties working with Strata) to disclose, use and maintain this information, including any and all Personal Identification Information and Personal Health information (collectively, the “Information”), to process and manage this application and any financial assistance that may be granted on the basis of this application, and for Strata’s internal document management, monitoring and auditing processes; and
c. The patient authorizes Strata (and/ or third parties working with Strata) to contact the patient and any other individual or entity identified by patient in the application, in connection with the application, including to disclose or use the Information to such individual or entity.