If a Caregiver declines to receive heart health data updates from you automatically, then you will still be able to manually share data with this Caregiver. They will simply not receive automatic updates, and “Autoshare Off” will show underneath the Caregiver in the Inner Circle tab.
If the Caregiver declined the automatic update by mistake, you can simply delete them as a caregiver in Kardia, then re add them to send another invite for Automatic updates.