Terms of Service

1. Acceptance and binding agreement

These Terms of Service constitute a legally binding agreement between you and CLARC LLC, doing business as CLARC Publishing (“CLARC,” “we,” “us,” or “our”). By accessing, viewing, searching, completing, downloading, printing, generating a report from, or otherwise using Respiratory Cloud or any related website, content, software, feature, or service (collectively, the “Service”), you acknowledge that you have read, understood, and agree to be bound by these Terms and any additional written terms that apply to a particular feature or authorized institutional arrangement.

If you do not agree, do not access or use the Service. Your electronic access to or use of the Service constitutes an electronic record of assent to the extent permitted by applicable law.

2. Definitions

“CLARC Content” means the protectable material owned by or licensed to CLARC and made available through the Service, including original source code, software, user-interface elements, page layouts, visual design, logos, marks, graphics, templates, report formats, taxonomies, organization, selection, coordination, arrangement, compilations, and original instructional expression. “Third-Party Materials” means publications, standards, guidelines, citations, trademarks, images, facts, data, or other material owned by or attributed to parties other than CLARC. “User Content” means information, text, selections, signatures, feedback, or other material entered, created, or submitted by a user.

3. Eligibility, authority, and institutional use

You may use the Service only if you have legal capacity to accept these Terms. If you use the Service on behalf of a school, employer, healthcare organization, clinical affiliate, government entity, or other organization, you represent that you are authorized to act for that organization and that both you and the organization will comply with these Terms. A minor may use the Service only with the authorization and supervision required by the minor's parent or legal guardian, educational institution, and applicable law.

4. Educational purpose; no medical, legal, accreditation, or regulatory advice

The Service is provided solely for education, study, laboratory practice, supervised training, and competency-development support. It does not provide medical, nursing, respiratory care, legal, regulatory, accreditation, risk-management, or insurance advice. Content is not intended to establish a diagnosis, treatment plan, prescription, legal duty, applicable standard of care, accreditation determination, licensure requirement, or institutional policy.

The Service is not an electronic health record, medical device, emergency-response system, credentialing platform, licensing authority, certifying body, or autonomous clinical decision-support system.

5. No replacement for education, training, competency validation, or professional judgment

The Service does not replace accredited education; classroom, laboratory, simulation, or clinical instruction; supervised practice; preceptorship; competency validation; credentialing; privileging; licensure; continuing education; direct observation; professional judgment; a complete patient assessment; current peer-reviewed evidence; current clinical practice guidelines; or a manufacturer's current instructions for use.

Completion of a checklist or report does not by itself establish knowledge, competence, certification, licensure, authorization to practice, employability, compliance with an accreditation standard, or satisfaction of any school, employer, clinical affiliate, regulator, payer, professional board, or insurer requirement.

6. Clinical authorization, lawful scope, orders, protocols, and supervision

Any treatment, procedure, medication administration, diagnostic activity, specimen collection, equipment adjustment, or other clinical intervention described in the Service may be performed only by persons who are appropriately educated, trained, licensed, certified, credentialed, privileged, competent, and authorized to perform it within their lawful scope of practice.

Clinical activities must be performed pursuant to a valid patient-specific order, approved protocol, standing order, or other lawful authorization issued by a licensed physician or another legally authorized ordering or prescribing practitioner; under the supervision or medical direction required by law, professional standards, facility policy, educational-program policy, and the user's role; and with all required institutional, departmental, supervising-clinician, and patient approvals. Students and trainees may perform clinical activities only under the level of direct supervision required by applicable law, the educational program, the clinical affiliate, facility policy, and the supervising clinician.

7. Independent verification and user responsibilities

You are solely responsible for determining whether and how information from the Service may be used in a particular educational or clinical setting. Before relying on or applying content, you must independently verify current and patient-specific information, including:

• orders, protocols, indications, contraindications, allergies, precautions, consent, goals, and assessment findings;
• federal, state, and local law; scope-of-practice requirements; accreditation standards; payer rules; and institutional policy;
• clinical practice guidelines, peer-reviewed evidence, medication information, dosing, warnings, recalls, and product labeling;
• device configuration, operating limits, alarms, maintenance status, infection-control requirements, and manufacturer instructions for use; and
• availability of qualified supervision, monitoring, emergency support, and escalation pathways.

You remain responsible for exercising independent professional judgment and for immediately seeking assistance whenever a patient's condition, your training, the available equipment, or the clinical circumstances exceed your competence or authority.

8. Prohibited clinical, educational, and recordkeeping uses

You may not use the Service to provide unauthorized, unlicensed, uncredentialed, unsupervised, fraudulent, deceptive, negligent, reckless, or unsafe care; to bypass an authorized order, approved protocol, supervising clinician, institutional policy, or manufacturer instruction; to delay emergency response; to impersonate another person; or to falsify, alter, backdate, misrepresent, or misuse a signature, score, evaluation, observation, report, credential, competency record, or clinical record.

You may not represent that CLARC has verified a user's identity, evaluator authority, direct observation, skill performance, competence, licensure, credential, or report authenticity.

9. Privacy, protected health information, and confidential data

Do not enter protected health information, personally identifiable patient information, student education records, confidential employer information, authentication credentials, or other regulated or sensitive data into the Service unless your organization has expressly authorized that use and all applicable privacy, security, consent, record-retention, data-governance, and contractual requirements have been satisfied.

The Service is not represented as a HIPAA-compliant electronic health record, a FERPA records system, or part of any designated medical or educational record. You are responsible for de-identification, lawful authorization, secure handling, storage, transmission, and deletion of any information you choose to enter or retain.

10. Reports, signatures, scoring, and competency records

Any checklist, score, selection, signature, date, timestamp, PDF, printout, or report created through the Service is generated from information entered or selected by the user. CLARC does not independently verify the user's identity, the evaluator's identity or authority, the conditions under which a skill was performed, the accuracy of an entry, the authenticity of a signature, or whether direct observation occurred.

Each institution and evaluator remains solely responsible for identity verification, direct observation, supervision, scoring, remediation, approval, countersignature, retention, security, acceptance, and legal or academic use of a report. Generated reports may be used only for lawful internal educational or institutional purposes consistent with these Terms and applicable policy.

11. User Content and feedback

As between you and CLARC, you retain any ownership rights you lawfully hold in User Content. You are responsible for ensuring that you have all rights, permissions, and lawful authority necessary to enter, use, reproduce, or share User Content. You may not enter content that infringes intellectual-property, privacy, confidentiality, publicity, contractual, or other rights.

If you voluntarily submit ideas, corrections, suggestions, or other feedback to CLARC, you grant CLARC a worldwide, perpetual, irrevocable, royalty-free, transferable, and sublicensable license to use, reproduce, modify, publish, distribute, and incorporate that feedback into its products and services without restriction or compensation, provided CLARC does not thereby acquire ownership of confidential information that CLARC expressly agreed in writing to receive as confidential.

12. Accuracy, completeness, currency, and changes in practice

Healthcare knowledge, standards, regulations, medications, devices, product labeling, and recommended practices change over time. Although CLARC may review and update content, CLARC does not warrant that every checklist, reference, statement, calculation, link, contraindication, or step is complete, current, accurate, error-free, or appropriate for every patient, device, jurisdiction, institution, educational level, or clinical circumstance.

A checklist is not a substitute for clinical reasoning, original-source review, professional verification, or current manufacturer documentation. CLARC may correct, revise, remove, or replace content at any time without notice.

13. Third-Party Materials, sources, and external services

The Service may identify, quote within lawful limits, summarize, cite, or refer to publications, professional organizations, manufacturers, government agencies, websites, or other third parties. Third-Party Materials remain the property of their respective owners and are subject to their own copyright, trademark, license, access, and use restrictions.

CLARC does not control and is not responsible for third-party availability, accuracy, completeness, security, privacy practices, licensing terms, continued suitability, or changes. A citation or reference does not constitute endorsement, sponsorship, affiliation, permission, or adoption of a third party's views.

14. Ownership of CLARC Content and reservation of rights

As between you and CLARC, CLARC LLC owns all right, title, and interest in and to CLARC Content, together with all associated copyrights, trademark rights, trade-dress rights, database and compilation rights, confidential-information rights, and other intellectual-property and proprietary rights, to the extent those rights are owned by or validly licensed to CLARC. All rights not expressly granted in these Terms are reserved.

CLARC's ownership includes, where protectable, the original software and source code; user-interface design; page and report layouts; graphics and logos; original wording and instructional expression; templates; taxonomy; selection, coordination, arrangement, and compilation of materials; and the overall look and feel of the Service. No ownership is claimed in facts, ideas, medical procedures, systems, methods of operation, public-domain materials, or Third-Party Materials beyond CLARC's protectable original expression, selection, coordination, or arrangement and any rights lawfully licensed to CLARC.

No use of the Service transfers ownership of any CLARC Content or grants any implied license, ownership interest, or right to use CLARC's names, logos, marks, or content except as expressly stated in these Terms or a separate written agreement signed by CLARC.

15. Limited, revocable license

Subject to continuous compliance with these Terms, CLARC grants you a limited, personal or authorized-institutional, revocable, nonexclusive, nontransferable, nonsublicensable license to access and use the Service for lawful study, classroom instruction, supervised laboratory or clinical education, and internal competency-evaluation purposes.

This license permits you to view CLARC Content and to print or save a reasonable number of user-completed reports for the user's or authorized institution's internal educational records. It does not permit public distribution, republication, commercial exploitation, creation of a content library or course product, or any use beyond the ordinary intended operation of the Service. Any broader institutional, commercial, publishing, integration, or redistribution right requires a separate written license signed by an authorized representative of CLARC.

16. Unauthorized use, copying, publication, and distribution prohibited

Except for the limited license expressly granted above, no person may use, reproduce, copy, download in bulk, archive, modify, translate, adapt, create derivative works from, publish, republish, upload, post, transmit, distribute, redistribute, sell, rent, lease, license, sublicense, assign, publicly display, publicly perform, syndicate, mirror, frame, embed, or otherwise exploit any CLARC Content without CLARC LLC's express prior written consent.

Without limiting the preceding paragraph, you may not:

• publish or republish CLARC Content in a book, article, manual, course pack, website, application, learning-management system available beyond an authorized class or institution, repository, database, social-media post, video, presentation, or other public or distributed work;
• copy or redistribute skill checklists, templates, report layouts, source code, styles, graphics, or a substantial portion of the Service;
• scrape, crawl, harvest, extract, index, mirror, cache, or systematically download CLARC Content through manual or automated means;
• use CLARC Content to create, train, fine-tune, evaluate, augment, or supply a machine-learning, generative-artificial-intelligence, retrieval, search, data-mining, or similar system or dataset;
• use CLARC Content to create or improve a competing or substantially similar product, service, curriculum, checklist library, assessment platform, publication, or database;
• remove, conceal, alter, or falsify copyright notices, trademark notices, attribution, watermarks, source information, access controls, or rights-management information; or
• authorize, assist, encourage, or enable another person to engage in a prohibited use.

Written consent is effective only if issued by an authorized representative of CLARC and specifically identifies the content, permitted use, users, term, territory, and any conditions. Silence, failure to object, prior informal discussion, or access to the Service does not constitute consent.

Nothing in these Terms is intended to restrict a right that applicable law makes nonwaivable, including a use that independently qualifies as fair use. The person asserting such a right remains responsible for determining its applicability and complying with all legal conditions.

17. Copyright notices, trademarks, and rights-management information

“CLARC,” “CLARC Publishing,” “Respiratory Cloud,” associated logos, and the distinctive visual presentation of the Service may be trademarks, service marks, trade names, or trade dress of CLARC LLC. You may not use them in a manner that suggests endorsement, sponsorship, affiliation, ownership, or authorization without prior written permission.

Copyright and proprietary notices must remain intact on every authorized copy. You may not knowingly remove or alter copyright-management information or circumvent technological measures controlling access to protected material.

18. Intellectual-property enforcement and equitable relief

Unauthorized use or disclosure of CLARC Content may cause harm that cannot be adequately remedied by money damages alone. In addition to any other rights and remedies, CLARC may seek injunctive or equitable relief, preservation of evidence, an accounting, damages, costs, and any other relief available under contract, copyright, trademark, unfair-competition, trade-secret, or other applicable law. CLARC's decision not to enforce a provision in one instance is not a waiver in another instance.

19. Copyright and infringement notices

If you believe material available through the Service infringes your copyright or other intellectual-property rights, send a written notice through the legal contact method published by CLARC. The notice should identify the protected work, identify the allegedly infringing material and its location, provide the complaining party's contact information, state a good-faith belief that the disputed use is not authorized, state under penalty of perjury that the notice is accurate and that the sender is authorized to act, and include a physical or electronic signature.

CLARC may remove or restrict access to disputed material while reviewing a notice. Nothing in this section represents that CLARC is entitled to a statutory safe harbor or that a particular notice satisfies all requirements of applicable law.

20. No professional or fiduciary relationship; emergencies

Use of the Service does not create a clinician-patient, physician-patient, educator-student, evaluator-trainee, supervisory, fiduciary, agency, employment, partnership, joint-venture, franchise, or other professional relationship with CLARC.

The Service is not designed for emergency decision-making. In an emergency or suspected emergency, immediately activate the applicable emergency response system, follow current resuscitation and facility protocols, and obtain assistance from qualified personnel.

21. Assumption of risk

You acknowledge that respiratory care procedures and related clinical interventions can involve substantial risk, including serious injury or death, when performed incorrectly, on an inappropriate patient, without current information, without proper equipment, outside a lawful scope of practice, without an authorized order or protocol, or without adequate supervision and monitoring. To the fullest extent permitted by law, you assume the risks arising from your use or misuse of the Service and from any decision to apply, omit, modify, teach, evaluate, publish, or rely on its content.

22. Disclaimer of warranties

TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, THE SERVICE AND ALL CONTENT ARE PROVIDED “AS IS” AND “AS AVAILABLE,” WITH ALL FAULTS AND WITHOUT WARRANTIES OF ANY KIND, EXPRESS, IMPLIED, OR STATUTORY. CLARC DISCLAIMS ALL WARRANTIES, INCLUDING WARRANTIES OF ACCURACY, COMPLETENESS, CURRENCY, RELIABILITY, AVAILABILITY, SECURITY, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, NON-INFRINGEMENT, PROFESSIONAL ACCEPTANCE, QUIET ENJOYMENT, AND SUITABILITY FOR CLINICAL, EDUCATIONAL, REGULATORY, ACCREDITATION, CREDENTIALING, OR RECORDKEEPING USE.

CLARC does not warrant uninterrupted, secure, accessible, or error-free operation; that defects will be corrected; that the Service is free of harmful components; or that any content or report will be accepted by an institution, regulator, accreditor, employer, payer, professional board, court, or other third party.

23. Limitation of liability

TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, CLARC AND ITS OWNERS, OFFICERS, MANAGERS, EMPLOYEES, CONTRACTORS, CONTRIBUTORS, LICENSORS, SERVICE PROVIDERS, AND AFFILIATES WILL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, CONSEQUENTIAL, OR PUNITIVE DAMAGES; PERSONAL INJURY OR DEATH; PROFESSIONAL DISCIPLINE; LOSS OR INVALIDATION OF RECORDS; LOSS OF DATA; LOSS OF REVENUE OR PROFITS; BUSINESS INTERRUPTION; LOSS OF EDUCATIONAL, ACCREDITATION, LICENSURE, CREDENTIALING, OR EMPLOYMENT OPPORTUNITY; OR OTHER LOSS ARISING FROM OR RELATED TO THE SERVICE, ITS CONTENT, RELIANCE ON THE SERVICE, INABILITY TO USE THE SERVICE, UNAUTHORIZED ACCESS, OR ANY CLINICAL, EDUCATIONAL, PUBLISHING, OR OTHER ACTION TAKEN OR OMITTED IN CONNECTION WITH IT, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, THE TOTAL AGGREGATE LIABILITY OF CLARC AND THE OTHER CLARC PARTIES FOR ALL CLAIMS ARISING FROM OR RELATED TO THE SERVICE WILL NOT EXCEED THE GREATER OF (A) THE AMOUNT YOU PAID DIRECTLY TO CLARC FOR THE SERVICE DURING THE TWELVE MONTHS PRECEDING THE EVENT GIVING RISE TO THE CLAIM OR (B) ONE HUNDRED U.S. DOLLARS (US $100). THESE LIMITATIONS APPLY REGARDLESS OF THE LEGAL THEORY ASSERTED AND ARE AN ESSENTIAL BASIS OF THE AGREEMENT.

Nothing in these Terms excludes or limits liability that cannot lawfully be excluded or limited. Some jurisdictions do not allow certain exclusions or limitations, so portions of this section may not apply to you.

24. Indemnification

To the maximum extent permitted by applicable law, you agree to defend, indemnify, and hold harmless CLARC and its owners, officers, managers, employees, contractors, contributors, licensors, service providers, and affiliates from claims, demands, actions, liabilities, damages, judgments, settlements, losses, penalties, fines, costs, and expenses, including reasonable attorneys' fees, arising from or related to your use or misuse of the Service; violation of these Terms; infringement or misappropriation of another person's rights; unauthorized publication or distribution of CLARC Content; falsification or misuse of a report or educational record; User Content; or unauthorized, unlicensed, negligent, reckless, or unsafe clinical or educational conduct, except to the extent a claim results from liability that applicable law does not permit CLARC to disclaim or shift.

25. Suspension, termination, and survival

CLARC may restrict, suspend, or terminate access to the Service, remove content, or pursue other remedies if CLARC reasonably believes that a user has violated these Terms, infringed rights, created legal or security risk, or used the Service in an unsafe or unauthorized manner. Upon termination, the license granted to you ends immediately and you must cease unauthorized use and delete unauthorized copies.

Provisions that by their nature should survive termination will survive, including provisions concerning ownership, restrictions, records, disclaimers, limitation of liability, indemnification, enforcement, governing law, and miscellaneous terms.

26. Governing law and venue

Except where applicable consumer-protection or other nonwaivable law requires otherwise, these Terms and any dispute arising from or related to the Service are governed by the laws of the State of Iowa, without regard to conflict-of-law principles. You consent to exclusive personal jurisdiction and venue in the state or federal courts having jurisdiction over Des Moines County, Iowa, and waive objections based on inconvenient forum to the extent permitted by law.

27. Miscellaneous legal terms

Severability. If a provision is held invalid or unenforceable, it will be enforced to the greatest extent permitted and the remaining provisions will remain in effect.

No waiver. A failure or delay in enforcing a right is not a waiver. A waiver must be in writing and signed by an authorized CLARC representative.

Assignment. You may not assign or transfer these Terms or any license without CLARC's prior written consent. CLARC may assign these Terms in connection with a merger, reorganization, sale of assets, financing, or operation of the Service.

Entire agreement and order of precedence. These Terms constitute the entire agreement concerning general use of the Service unless a separate written agreement signed by CLARC applies. If a signed agreement conflicts with these Terms, the signed agreement controls for its subject matter.

No third-party beneficiaries. Except for the CLARC parties expressly protected by warranty, liability, and indemnification provisions, these Terms create no third-party beneficiary rights.

Force majeure. CLARC is not liable for delay or failure caused by circumstances beyond its reasonable control, including internet, hosting, utility, governmental, labor, supply-chain, security, disaster, epidemic, or similar events.

Interpretation. Headings are for convenience only. “Including” means “including without limitation.” Singular and plural terms include each other where context permits.

28. Changes to the Service and these Terms

CLARC may revise the Service or these Terms from time to time. Material changes will be posted with a revised effective date and, when reasonably appropriate, additional notice. Changes apply prospectively unless applicable law permits otherwise. Continued use after the effective date of revised Terms constitutes acceptance of the revised Terms.

29. Contact and legal notices

Questions, permission requests, infringement notices, or other legal notices concerning the Service may be submitted through the contact method published on Respiratory Cloud. A notice should identify the sender, provide reliable contact information, describe the matter in reasonable detail, identify the specific content or conduct at issue, and include any supporting documentation.

No request for permission is granted unless CLARC provides express written consent through an authorized representative.