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International Medical Group, Inc. WARNING! This computer system is the property of International Medical Group, Inc. (“IMG”) and may be accessed only by IMG employees and authorized users. Unauthorized access, use, or modification of this system or of the data contained herein, or in transit to/from this system is strictly prohibited and may be subject to termination of employment or criminal prosecution. This system contains sensitive U.S. Government data. IMG may monitor, record, or audit any activity or communication on the system and retrieve any information stored within the system. By accessing and using this computer, you acknowledge receipt of, understand your responsibilities under, and will comply with applicable laws and the rules of behavior for IMG’s system. In addition, you are consenting to such monitoring, recording, auditing, and information retrieval for IMG, auditors, law enforcement, and other related purposes. Unauthorized use or policy infractions should be reported to the IMG Systems Support at systemssupport@imglobal.com.

Privacy Act Statement: Authorities – This information is requested pursuant to 42 U.S.C. 4955, Support services; 42 U.S.C. 12618, Authorized benefits for Corps members; and 45 CFR § 2556.320 – What benefits may a VISTA receive during VISTA service? Purposes – It is requested to manage and evaluate the health benefits programs offered to VISTA, NCCC, and FEMA Corps Members. Routine Uses – Routine uses of this information may include disclosure to (1) health care providers and insurance companies to provide care and coordinate payment, (2) contractors to assist with providing the health care benefit, and (3) federal, state, or local agencies pursuant to lawfully authorized requests. Effects of Nondisclosure – This request is voluntary, but not providing the information will likely affect your ability to receive your health care benefits.