Last Updated: 18 Aug 2026
The Gradient Platform (defined below) is owned and operated by Gradient Health, Inc.
To make these Terms of Service (“Terms”) easier to read, we will sometimes refer to Gradient Health, Inc. (including our directors, officers, members, managers, employees, service providers, affiliates, successors and assigns) as “Gradient” "our", "we", or "us"; we will refer to you as “Customer”, "you" or a derivative of you; and we will refer to user(s) of the Service (including you) as "User(s)". These Terms apply when you browse or use the Gradient Health website located at https://gradienthealth.io (the "Site", a component of the "Service"), when you use the Gradient Platform (defined below) or otherwise access or receive Gradient Data (defined below), or in any way access or utilize any other components of the Service (defined below), if any and when available.
THE SERVICE AND FEES
Gradient maintains a database of aggregated, de-identified medical imagery and related information (the “Gradient Data”), which it makes available through a web-based platform called Atlas; through an SQL interface referred to as BigQuery; and/or through curated data files delivered directly by Gradient (collectively, the “Gradient Platform”). All medical imagery and related data that Gradient provides or makes accessible to you via any means or methods is also considered “Gradient Data” for the purpose of these Terms. The “Service” includes the Gradient Platform, Gradient Data, and all other services, tools, technology, documentation, content, and features provided by Gradient . Users can search, view, access, and download Gradient Data, all subject to the licenses and restrictions set forth herein.
By using the Service, you accept and agree to be bound and abide by these Terms, which create a binding legal agreement between you and Gradient. Certain features of the Service may be subject to additional guidelines, terms, or rules, which may be set forth in a separate written agreement between you and Gradient, or posted on the Site in connection with such features. All such additional terms, guidelines, and rules are incorporated by reference into these Terms. If you do not agree to these Terms, you are expressly prohibited from using the Service and you must discontinue immediately.
Supplemental terms and conditions or documents that we may post on the Service from time to time are hereby expressly incorporated herein by reference. Gradient reserves the right, in its sole discretion, to modify these Terms at any time and for any reason. We will alert you about any changes by updating the “Last updated” date of these Terms, and you waive any right to receive specific notice of each such change.
The Gradient Data and information provided through the Service is not intended for distribution to or use by any person or entity in any jurisdiction or country where such distribution or use would be contrary to law or regulation or which would subject us to any registration requirement within such jurisdiction or country. Accordingly, anyone who chooses to access the Service from other locations does so on their own initiative and is solely responsible for compliance with local laws, if and to the extent local laws are applicable.
Notwithstanding anything to the contrary herein, Customer is explicitly prohibited from, directly or indirectly: (1) transferring any Data to, or permitting any person or entity to access any Data from, any country that is subject to legal or commercial sanctions imposed by the United States, or any "country of concern" as designated from time to time under 28 C.F.R. Part 202, which as of the Last Updated Date comprise the People's Republic of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, and Venezuela (each, a "Country of Concern"); (2) in any way permitting or assisting any other person or entity to transfer any Data to, or access any Data from, any country that is subject to legal or commercial sanctions or regulations imposed by the United States, or any Country of Concern; or (3) attempting any of the foregoing. Customer further represents, warrants, and covenants on a continuing basis that: (a) Customer is not, and is not owned fifty percent (50%) or more, individually or in the aggregate, directly or indirectly, by, and is not otherwise subject to the ownership, direction, or control of, any Country of Concern or any "covered person" as defined at 28 C.F.R. § 202.211 (a "Covered Person"); (b) no Authorized User, employee, contractor, or agent of Customer who has or will have access to the Data is a Covered Person or is primarily resident in a Country of Concern; (c) Customer shall not knowingly provide, transfer, sell, license, or otherwise make the Data available to, or permit access to the Data by, any Country of Concern or Covered Person; and (d) Customer shall notify Gradient in writing within five (5) business days of becoming aware of any change in circumstances that would render any of the foregoing representations inaccurate, or of any actual or suspected access to the Data by a Country of Concern or Covered Person. Customer acknowledges that Gradient is subject to reporting obligations under 28 C.F.R. Part 202 and agrees to provide such information as Gradient reasonably requires to satisfy those obligations.
Visiting the Service, sending us emails, and completing online forms constitute electronic communications. You consent to receive electronic communications, and you agree that all agreements, notices, disclosures, and other communications we provide to you electronically, via email and on the Service, satisfy any legal requirement that such communication be in writing.
By using the Service, you represent and warrant that you are of legal age to form a binding contract with Gradient and use the Service in accordance with these Terms. If you register and use the Service on behalf of another entity or third party, you must have the proper authority to register, use the Service, and bind the entity or third party for which you are using the Service. If you do not meet these requirements or, if for any reason, you do not agree with all of the terms and conditions contained in these Terms, you must stop using the Service immediately.
You must create an account (“User Account”) to access the Gradient Platform. You agree to keep your password confidential. You agree not to share your User Account with others or provide access to your account to any third party. You will be responsible for all use of your User Account and password.
You may sign up to use the Service to order Gradient Data by paying the Fees, as outlined on a proposal you will review and approve before receiving Gradient Data (“Fees”).
You agree to provide current, complete, and accurate purchase and account information for all purchases made via the Service. You further agree to promptly update account and payment information, including email address, payment method, and payment card expiration date, so that we can complete your transactions and contact you as needed.
We bill you through an online billing account for purchases made via the Service. Sales tax will be added to the price of purchases as we deem required. All payments shall be in U.S. dollars.
We may change prices we charge for the Service at any time. We will provide advance notice of any price changes that may impact you. Any price changes we make will apply to orders of Gradient Data that you place after we notify you of such price changes. . If you and Gradient agree to a special order of Gradient Data, the fees may differ. Any special order fees will be set forth in a separate proposal or written order between you and Gradient.
You agree to pay all charges or fees at the prices then in effect for your order(s), and you authorize us to charge your chosen payment provider for any such amounts.We also reserve the right to refuse any order placed through the Service. We will not be liable for any insufficient funds or other charges you may incur as a result of any attempts to charge and/or place holds on your credit card.
In cases where Gradient will deliver Gradient Data to Customer directly, delivery will be via access to a data storage bucket that is owned and managed by Gradient. Gradient will store the data in the location specified at time of delivery for a period of ninety (90) days. After ninety (90) days, Gradient may delete the Gradient Data and Customer will have to initiate a new request if they failed to download that Gradient Data and need it again.
In exceptional cases where Customer is not able to access the data storage bucket, an alternative method delivery can be arranged upon request. Any costs associated with this custom delivery method are subject to discussion and final approval by Gradient.
In cases where the Gradient Data delivered to Customer does not meet the expected requirements, Customer may submit a support request via email to support@gradienthealth.io within thirty (30) days from delivery, specifying the reason why the Gradient Data did not meet the Customer’s requirements. Gradient shall evaluate all return requests and re-credit the Customer's Gradient Data quota in the amount of studies approved for credit. Gradient has sole discretion over this process, and may or may not determine that Customer is entitled to a credit on their account. Customer shall not be entitled to any financial refunds.
Your access to the Service will begin when you approve and sign a proposal for an order of Gradient Data and shall continue for one (1) year from the Start Date (“Initial Period”). Your access to the Service will automatically renew on a month-to-month basis each year on the anniversary of your Start Date, subject to termination as set forth below. The time from the date Customer first accesses the Service until the last day Customer uses the Service shall be the “Term”.
You may cancel your account by providing Gradient with written notice, and such cancellation will take effect as of the later of: (A) thirty (30) days from the date of such written notice. All purchases are non-refundable.
Regardless of whether Gradient or Customer terminates Customer’s account and access to the Service, and regardless of the reason for such termination, Customer will pay in full for any orders for Gradient Data placed through the Service and delivered by Gradient. Customer will not be charged Fees after the Term, other than fees that accrued prior to termination. Customer may not access the Service or download any additional Gradient Data following termination; however, Customer may retain a copy of any Gradient Data Customer actually downloaded prior to termination for use consistent with these Terms.
In the event of any cancellation or termination of your account, we may restrict access to the Service, or any component of the Service, or any Gradient Data, content, or other material that you may have used in connection with the Service. The restriction of your use of the Service shall survive such termination, and you agree to be bound by those terms. We reserve all rights that are not expressly granted to you under these Terms.
These Terms shall remain in full force and effect for as long as you use the Service. WITHOUT LIMITING ANY OTHER PROVISION OF THESE TERMS OF USE, WE RESERVE THE RIGHT TO, IN OUR SOLE DISCRETION AND WITHOUT NOTICE OR LIABILITY, DENY ACCESS TO AND USE OF THE SERVICE (INCLUDING BLOCKING CERTAIN IP ADDRESSES), TO ANY PERSON FOR ANY REASON OR FOR NO REASON, INCLUDING WITHOUT LIMITATION FOR BREACH OF ANY REPRESENTATION, WARRANTY, OR COVENANT CONTAINED IN THESE TERMS OR OF ANY APPLICABLE LAW OR REGULATION.
WE MAY TERMINATE YOUR USE OR PARTICIPATION IN THE SERVICE OR DELETE YOUR USER ACCOUNT, WITHOUT WARNING, IN OUR SOLE DISCRETION.
If we terminate or suspend your User Account for any reason, you are prohibited from registering and creating a new account under your name, a fake or borrowed name, or the name of any third party, even if you may be acting on behalf of the third party.
In addition to terminating or suspending your account, we reserve the right to take appropriate legal action, including without limitation pursuing civil, criminal, and injunctive redress.
“Authorized User” means any employee, contractor, or agent who is authorized by an entity Customer to use the Service under the rights granted to the entity Customer pursuant to this Agreement. For clarity, each Authorized User shall have a separate User Account.
“Technology” means the all computer programs, software, source code, object code, algorithms, underlying technical structure, ideas, know-how, processes, systems, documentation and information comprising the Gradient Platform or the Service, or otherwise developed or provided by Gradient in connection with the Gradient Platform or the Service, and all intellectual property rights related to the foregoing.
Gradient represents to Customer that Gradient has the rights and licenses necessary for Gradient to license the Gradient Data to Customer as provided pursuant these Terms.
Notwithstanding anything to the contrary in these Terms, and provided that Customer is not in breach of these Terms including any payment obligations hereunder, Customer may transfer the Gradient Data Customer has downloaded from the Gradient Platform to its successor in interest in connection with a merger or acquisition involving Customer. Customer must notify Gradient and obtain Gradient’s prior written consent before transferring Gradient Data in connection with a merger or acquisition event, but Gradient shall not unreasonably withhold such consent.
We May Update the Service Periodically & We Do Not Guarantee Access to the Service at Any Given Time
Gradient seeks to work with those working to make a better world for patients. This means we are making an ethical commitment in our business processes to only provide Gradient Data to companies whose goals are to have direct, positive impact upon patients. Projects and technologies we seek to support include those intended to: directly assist in patient care; find patients with undiagnosed disease for clinical trial recruitment; and make radiologies and other care providers more efficient or precise in caring for patients.
This means you are not permitted to use any Gradient Data to further any projects or technologies that are intended or created to target patient marketing; adjust or reject health insurance claims; discriminate against patients with pre-existing disease or other protected status; identify individuals; increase function of disease or adversely affect the care or treatment of disease; or otherwise directly or indirectly harm patients. The ethical standards described in this section are in addition to all other use restrictions specified in these Terms.
Countries of Concern; Covered Persons. Notwithstanding anything to the contrary herein, Customer is explicitly prohibited from, directly or indirectly: (1) transferring any Data to, or permitting any person or entity to access any Data from, any country that is subject to legal or commercial sanctions imposed by the United States, or any "country of concern" as designated from time to time under 28 C.F.R. Part 202, which as of the Last Updated Date comprise the People's Republic of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, and Venezuela (each, a "Country of Concern"); (2) in any way permitting or assisting any other person or entity to transfer any Data to, or access any Data from, any country that is subject to legal or commercial sanctions or regulations imposed by the United States, or any Country of Concern; or (3) attempting any of the foregoing. Customer further represents, warrants, and covenants on a continuing basis that: (a) Customer is not, and is not owned fifty percent (50%) or more, individually or in the aggregate, directly or indirectly, by, and is not otherwise subject to the ownership, direction, or control of, any Country of Concern or any "covered person" as defined at 28 C.F.R. § 202.211 (a "Covered Person"); (b) no Authorized User, employee, contractor, or agent of Customer who has or will have access to the Data is a Covered Person or is primarily resident in a Country of Concern; (c) Customer shall not knowingly provide, transfer, sell, license, or otherwise make the Data available to, or permit access to the Data by, any Country of Concern or Covered Person; and (d) Customer shall notify Gradient in writing within five (5) business days of becoming aware of any change in circumstances that would render any of the foregoing representations inaccurate, or of any actual or suspected access to the Data by a Country of Concern or Covered Person. Customer acknowledges that Gradient is subject to reporting obligations under 28 C.F.R. Part 202 and agrees to provide such information as Gradient reasonably requires to satisfy those obligations.
Customer agrees that it shall implement, maintain, monitor, and comply with the following data security requirements in connection with the access, receipt, and use of the Gradient Data.
Definitions. As used in this Data Security Requirements section, each of the following terms shall have the corresponding meaning set forth below.
“Applications” means all externally-facing applications that receive, access, process or store Gradient Data.
“Customer Personnel” means all employees, contractors, agents, and third-party service providers employed or contracted by Customer for any purpose.
“Customer System” means all tools, technologies, hosting services, processes, information management systems, and other hardware and software used by Customer.
“Encryption” means the reversible transformation of data from the original (plaintext) to an obfuscated format (cipher text) as a mechanism for protecting the information’s confidentiality, integrity and/or authenticity. Encryption requires an encryption algorithm and one or more encryption keys.
“Encryption Standard” means the most current industry standard information encryption standards and methodologies, unless another standard is authorized in writing by Gradient.
“Personal Information” is information that: (i) directly or indirectly identifies an individual (including, for example, names, signatures, addresses, telephone numbers, email addresses, and other unique identifiers); or (ii) can be used to authenticate an individual (including, without limitation, employee identification numbers, government-issued identification numbers, passwords or PINs, user identification and account access credentials or passwords, biometric, genetic, health, or health insurance data, answers to security questions, and other personal identifiers). Personal Information includes Protected Health Information.
“Protected Health Information” shall have the same meaning as the term “protected health information” in 45 CFR §160.103.
“Security Incident” means any actual or threatened security breach in or unauthorized or suspicious access to any Customer System that would adversely affect the Gradient Data, Service, systems or access to the Customer System.
“Store” means to save, archive, back-up information, and/or perform any similar activities.
Specific Security Requirements.
Contents of the Customer Information Security Program. The Customer Information Security Program shall contain a comprehensive set of written security policies and procedures in accordance with industry best practices, which cover, at a minimum:
Customer Responsibilities.
Physical and Environmental Security. Customer shall:
Communications and Operations. Customer shall:
Access Control. Customer shall:
Safeguards. The Customer Information Security Program shall contain administrative, technical, and physical safeguards to ensure the confidentiality of the Gradient Data (as applicable) and Confidential Information and protects against (a) any anticipated threats or hazards to the security or integrity of the Gradient Data, Confidential Information, and sensitive information; and (b) unauthorized, accidental and inadvertent (i) access or damage to, or (ii) acquisition, modification, disclosure, destruction, use or misuse of, the Gradient Data and any Confidential Information.
Security Incident Management. Customer shall:
Compliance. Customer shall:
The Service may contain links, special features, or third-party materials that are not owned or controlled by Gradient. We may refer you to certain third parties who provide independent services relating to or supporting your use of the Service, and/or certain features or functionality of the Service may require your use of, or may be compatible with or connected to, third-party services, sites, information, materials, products, applications, extensions, or services (each a “Third-Party Service”). If you use a Third-Party Service, you are subject to and agree to the third party’s terms of service (or other applicable terms and conditions) made available by the Third-Party Service, as applicable. We do not endorse or assume any responsibility for any such Third-Party Service, even if we have performed a review of the functionality of such Third-Party Service, and even if we make the Third-Party Service available to you as an enhanced feature of the Service, for example. If you access a Third-Party Service from the Service or otherwise use a Third-Party Service in connection with your use of the Service, you do so at your own risk and you understand and agree that these Terms do not apply to your use of such Third-Party Services. You expressly release Gradient from any and all liability arising from your use of a Third-Party Service.
INDEMNIFICATION, DISCLAIMERS, & LIMITATION OF LIABILITY
DISCLAIMER OF WARRANTIES
TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT WILL GRADIENT OR ANY OF ITS AFFILIATES, SUPPLIERS, OR LICENSORS (OR OUR OR THEIR OFFICERS, DIRECTORS, SHAREHOLDERS, REPRESENTATIVES, CONTRACTORS OR EMPLOYEES) BE RESPONSIBLE OR LIABLE UNDER OR IN CONNECTION WITH THESE TERMS UNDER ANY LEGAL OR EQUITABLE THEORY, INCLUDING BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY, AND OTHERWISE, FOR ANY: (I) CONSEQUENTIAL, INCIDENTAL, INDIRECT, EXEMPLARY, SPECIAL, ENHANCED, OR PUNITIVE DAMAGES; (II) INCREASED COSTS, DIMINUTION IN VALUE OR LOST BUSINESS, PRODUCTION, REVENUES, OR PROFITS; (III) LOSS OF GOODWILL OR REPUTATION; (IV) USE, INABILITY TO USE, LOSS, INTERRUPTION, DELAY OR RECOVERY OF ANY DATA, OR BREACH OF DATA OR SYSTEM SECURITY; OR (V) COST OF REPLACEMENT GOODS OR SERVICES, IN EACH CASE REGARDLESS OF WHETHER GRADIENT WAS ADVISED OF THE POSSIBILITY OF SUCH LOSSES OR DAMAGES OR SUCH LOSSES OR DAMAGES WERE OTHERWISE FORESEEABLE.
TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT WILL GRADIENT’S AGGREGATE LIABILITY ARISING OUT OF OR RELATED TO THESE TERMS UNDER ANY LEGAL OR EQUITABLE THEORY EXCEED TWO (2) TIMES THE TOTAL AMOUNTS PAID TO GRADIENT UNDER THESE TERMS IN THE ONE (1) YEAR PERIOD PRECEDING THE EVENT GIVING RISE TO THE CLAIM.
DISPUTES
Informal Negotiation
To expedite resolution and control the cost of any dispute, controversy, or claim related to these Terms (each a "Dispute" and collectively, the “Disputes”) brought by either you or us (individually, a “Party” and collectively, the “Parties”), the Parties agree to first attempt to negotiate any Dispute (except those Disputes expressly provided below) informally for at least sixty (60) days before initiating arbitration. Such informal negotiations commence upon written notice from one Party to the other Party.
If the Parties are unable to resolve a Dispute through informal negotiations, the Dispute will be finally and exclusively resolved by binding arbitration. YOU UNDERSTAND THAT WITHOUT THIS PROVISION, YOU WOULD HAVE THE RIGHT TO SUE IN COURT AND HAVE A JURY TRIAL.
The arbitration shall be commenced and conducted under the Commercial Arbitration Rules of the American Arbitration Association ("AAA") and, where appropriate, the AAA’s Supplementary Procedures for Consumer Related Disputes ("AAA Consumer Rules"), both of which are available at the AAA website www.adr.org.
Your arbitration fees and your share of arbitrator compensation shall be governed by the AAA Consumer Rules and, where appropriate, limited by the AAA Consumer Rules.
The arbitration may be conducted in person, through the submission of documents, by phone, or online. The arbitrator will make a decision in writing, but need not provide a statement of reasons unless requested by either Party. The arbitrator must follow applicable law, and any award may be challenged if the arbitrator fails to do so. Except where otherwise required by the applicable AAA rules or applicable law, the arbitration will take place in Wake County in North Carolina.
Except as otherwise provided herein, the Parties may litigate in court to compel arbitration, stay proceedings pending arbitration, or to confirm, modify, vacate, or enter judgment on the award entered by the arbitrator.
If for any reason, a Dispute proceeds in court rather than arbitration, the Dispute shall be commenced or prosecuted in the state and federal courts located in Wake County, North Carolina, and the Parties hereby consent to, and waive all defenses of lack of personal jurisdiction, and forum non conveniens with respect to venue and jurisdiction in such state and federal courts.
Application of the United Nations Convention on Contracts for the International Sale of Goods and the Uniform Computer Information Transaction Act (UCITA) are excluded from these Terms of Use.
In no event shall any Dispute brought by either Party related in any way to the Service be commenced more than one (1) year after the cause of action arose. If this provision is found to be illegal or unenforceable, then neither Party will elect to arbitrate any Dispute falling within that portion of this provision found to be illegal or unenforceable and such Dispute shall be decided by a court of competent jurisdiction within the courts listed for jurisdiction above, and the Parties agree to submit to the personal jurisdiction of that court.
Digital Millennium Copyright Act (“DMCA”) Notice & Policy
We respect the intellectual property rights of others. If you believe that any material available on or through the Service infringes upon any copyright you own or control, please immediately notify our Designated Copyright Agent using the contact information provided below (a “Notification”).
A copy of your Notification will be sent to the person who posted or stored the material addressed in the Notification. Please be advised that pursuant to federal law you may be held liable for damages if you make material misrepresentations in a Notification. Thus, if you are not sure that material located on or linked to by the Service infringes your copyright, you should consider first contacting an attorney.
All Notifications should meet the requirements of DMCA 17 U.S.C. § 512(c)(3) and include the following information:
(1) A physical or electronic signature of a person authorized to act on behalf of the owner of an exclusive right that is allegedly infringed;
(2) identification of the copyrighted work claimed to have been infringed, or, if multiple copyrighted works on the Service are covered by the Notification, a representative list of such works on the Service;
(3) identification of the material that is claimed to be infringing or to be the subject of infringing activity and that is to be removed or access to which is to be disabled, and information reasonably sufficient to permit us to locate the material;
(4) information reasonably sufficient to permit us to contact the complaining party, such as an address, telephone number, and, if available, an email address at which the complaining party may be contacted;
(5) a statement that the complaining party has a good faith belief that use of the material in the manner complained of is not authorized by the copyright owner, its agent, or the law;
(6) a statement that the information in the notification is accurate, and under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed upon.
Submissions
We May Amend These Terms & Make Corrections
We may revise and update these Terms from time to time in our sole discretion. All changes become effective immediately when we post them. We will notify you of material changes to the Terms, or any changes that require your consent, by sending an email to the email address you provided to us. For this reason, you should keep your contact information current. We may not be able to provide you with email notice if you are using features of the Service that do not require you to submit any information that could be used to contact you, so please check the Site periodically for changes.
There may be information on the Service or Gradient Data that contains typographical errors, inaccuracies, or omissions, including descriptions, pricing, availability, and various other information. We reserve the right to correct any errors, inaccuracies, or omissions and to change or update the information on the Service or Gradient Data at any time, without prior notice.
In order to resolve a complaint regarding the Service or to receive further information regarding use of the Service, please contact us at:
Gradient Health, Inc.
110 Corcoran Street
Fifth Floor
Durham, NC 27701
support@gradienthealth.io
