THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The Pharmacy is required by law to maintain the privacy of the health information it maintains about its customers (also known as “Protected Health Information” or “PHI”) and to provide its customers with notice of our legal duties and privacy practices with respect to PHI. PHI is information that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose PHI to carry out treatment, obtain payment or perform our health care operations and for other specified purposes that are permitted or required by law. This Notice also describes your rights with respect to PHI about you.
The Pharmacy will follow the practices described in this Notice. Except as described in this Notice, we will not use or disclose PHI about you without your written authorization. We reserve the right to change our practices and this Notice. In the event that we revise this Notice, the new Notice provisions will be effective for all PHI we maintain. We will provide you with a revised Notice upon request.
The following categories describe different ways that we may use and disclose your PHI. Examples of such uses or disclosures are provided for each category. These are provided for illustrative purposes only and not every use or disclosure within each category is listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories below.
In addition, we may use or disclose your PHI for the following purposes.
Finally, we may use or disclose PHI about you for the following purposes:
The Pharmacy must obtain your written authorization before using or disclosing PHI about you for purposes other than those provided for above or as otherwise permitted or required by law. For example, in limited circumstances, state or federal law (that provides special privacy protections for certain types of highly sensitive health information) may require the Pharmacy to obtain your authorization to use or disclose sensitive health information.
You may revoke an authorization in writing at any time. Upon receipt of a written revocation, we will stop using or disclosing PHI about you, except to the extent that we already have taken action in reliance on the authorization.
You have the following rights with respect to your PHI that we maintain:
If you have questions or would like additional information about the Pharmacy’s privacy practices, you may contact us in person or by mail addressed to our pharmacy location and directed to “Attention: HIPAA Privacy Official”.
If you believe your privacy rights have been violated, you may submit a complaint via the contact information address set forth above. There will be no retaliation for filing such a complaint.
We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all your PHI that we maintain, including any information created or received prior to issuing the new notice.
If we change this Notice, we will post the new notice on our website. You also may obtain any new notice by contacting us through our website, in person or by mail addressed to our pharmacy location and directed to “Attention: HIPAA Privacy Official”.