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THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT
YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW
IT CAREFULLY.
This notice
describes the privacy practices of Pharmacy Medications. This company and its
staff have agreed to the terms of this Notice of Privacy Practices.
This
privacy notice and the privacy practices explained in this notice notify you of
their commitment to protecting private health information, and permitting patients
to exercise their rights concerning health information. No legal relationship
between these medical staff and companies is created or implied for any other
purpose.
your health
care information is your personal information. the pharmacy know that information about
your medical history and your health care is private. To process orders, the pharmacy must
create certain records which contain information about your health. These
records include questionnaires, profiles, and billing
records.
The law
requires that the pharmacy give you written notice of their privacy practices, and requires
that the pharmacy follow the terms of their privacy notice currently in effect. This Notice
of Privacy Practices describes their commitment and the commitment of their
employees and contractors to the protection and confidentiality of your health
information. This notice also describes your rights concerning your health
information, including your right to inspect and amend your health information.
the pharmacy are committed to following the law which requires that protected health
information is kept private subject to legal requirements which authorize or
require its disclosure in limited circumstances.
How
the pharmacy May Use and Disclose Health Information Unless the pharmacy have
your written authorization, the pharmacy will not use and disclose your protected health
information, except under the limited circumstances explained below. the pharmacy will not
disclose protected health information about you for any other reason without
your written authorization. If you give us an authorization permitting us to
release protected health information, you may revoke the authorization in
writing, except to the extent the pharmacy have already disclosed information pursuant to
the authorization.
A.
Health Information is Used to Allow Us to Fill your
Orders.
the pharmacy may use or
disclose your protected health information for the purpose of providing
treatment to you through the filling of orders and allowing their staff to
evaluate whether their products are appropriate for you. For example, if you
request a product, a licensed physician will evaluate whether you meet the
criteria to receive that product based upon your health information provided to
the physician. The request for that product, along with information you have
provided concerning your health, will be provided to a licensed pharmacy for the
purpose of filling the order.
B.
Limited Information is Used to Obtain Payment for Product
Orders. the pharmacy obtain payment
for their services through your credit card company or through a check processing
service. The only information the pharmacy share with your credit card company or check
processing service is your name, billing address and phone number, and credit
card number. For customers paying by check, the pharmacy also provide your checking
account number to a check processing service. the pharmacy do not share any information
with your credit card company or check processing service which discloses the
type of product dispensed to their customers. All personal and credit card
information is submitted using Secure Encryption
Technology.
C.
Information May Be Used for Health Care Operations. the pharmacy may use or
disclose health care information for their operations. For example, the pharmacy may use
information concerning your order to evaluate the quality of care and services
their staff is providing to you. Pharmacy Medications, affiliated the pharmacybsites, the
physicians, and pharmacies involved with your care may also disclose health care
information to each other as necessary to assist them with providing treatment
to you, operating their companies, or to obtain payment.
D.
Reorder Reminders and Information about Treatment
Alternatives. the pharmacy may use health
care information to contact you by e-mail for the purpose of reminding you of
your ability to obtain reorders, or inform you about treatment alternatives or
other health related benefits and services that may be of interest to you.
Please advice their Privacy Officer by e-mail or
U.S. mail at the privacy contact
address described at the end of this Notice if you do not wish us to contact you
concerning reorder reminders, treatment alternatives, or other health related
benefits and services that may be of interest to you.
E.
Disclosures as Required by Law. the pharmacy may use or
disclose protected health information if required to do so by federal, state, or
local law. The use or disclosure will be made in compliance with the law, and
will be limited to the relevant requirements of the law. For example, the pharmacy may be
required to disclose your health information in relation to cases of suspected
abuse, neglect, domestic violence or certain physical injuries, or to respond to
a subpoena, or order of a ctheirt or administrative
tribunal.
F.
Disclosures for Public Health Activities. the pharmacy may be required
to disclose protected health information for public health activities to a
public health authority authorized by law to collect or receive this
information, such as the Food and Drug Administration, for the purpose of
preventing or controlling disease, injury, or disability.
G.
Disclosures to Coroners and Medical Examiners. the pharmacy may be required to
disclose health information about patients who have died to coroners and medical
examiners so they may carry out their duties, such as determining the cause of
death.
H.
Disclosures Concerning Organ Donors. If you are an organ
donor, the pharmacy may be asked to disclose information concerning your health or
products the pharmacy have dispensed to organ procurement organizations, eye banks, and
other similar organizations for the purpose of facilitating organ, eye or tissue
donation and transplantation.
I.
Disclosures to Avert a Serious Threat to Health. As required by law
and standards of ethical conduct, the pharmacy are permitted to release your health
information to the proper authorities if the pharmacy believe, in good faith, that such
release is necessary to prevent or minimize a serious and imminent threat to
your, the public's, or another individual's health or
safety.
J.
Disclosures for Health Oversight Activities. the pharmacy are permitted to
disclose your health information to a health oversight agency for monitoring and
oversight activities authorized by law. This might include release of
information to the state agency that licenses pharmacies for the purpose of
monitoring or inspecting pharmacies related to that
license.
K.
Disclosures for Workers Compensation Purposes. the pharmacy may be required
to release protected health information about you to the extent necessary to
follow the laws relating to workers compensation or other similar programs that
provide benefits for work related injuries or illness.
L.
Disclosures to Business Associates. the pharmacy may request
certain businesses to assist us with their health care operations. In the event it
is necessary to disclose protected health information pertaining to their
customers to these business associates, the pharmacy will enter into written contracts
with them requiring that they keep protected health information private and
secure.
your Rights
Pertaining to your Health Care Information
A.
Right to Request Confidential Communications. the pharmacy intend to
communicate with their customers primarily by e-mail at the e-mail address which
you provided to us and to ship orders to the shipping address you have provided.
You have the right to request that the pharmacy communicate with you in a certain way or
at a certain location. For example, you can ask that the pharmacy only contact you by
U.S. mail at a private post office
box. the pharmacy will not ask you the reason for your request.
To request
the pharmacy communicate with you to a specific location, or in a particular manner,
please obtain their "Request for Communications via Specific Means or at
Alternative Locations" form by contacting their Privacy Officer as described later
in this Notice, and submit the completed form to their Privacy Officer by e-mail
or U.S. mail. the pharmacy will accommodate all reasonable requests.
B.
Right to Request Restrictions. You have the right
to ask for restrictions on how your health information is used or to whom your
information is disclosed, even if the restriction affects your treatment, their
payment, or health care operation activities. however, the pharmacy are not required to
agree to your requested restriction and, even if the pharmacy agree to the requested
restriction, the pharmacy are permitted to use your information without complying with the
restriction if necessary to treat you in an emergency
situation.
To request a
restriction, please obtain their "Request for Restrictions on the Use and
Disclosure of Health Information" form by contacting their Privacy Officer as
described later in this Notice, and submit the completed form to their Privacy
Officer by e-mail or
U.S. mail.
C.
your Right to Inspect and Obtain a Copy of your Health
Information. You have the right to
inspect and obtain a copy of health information that the pharmacy maintain about you. This
includes order records and billing records. To inspect or request a copy of your
health information, please contact and obtain their "Request to Copy or Inspect
Records" form from their Privacy Officer as described later in this Notice, and
submit the completed form to their Privacy Officer specifying the records you
would like to inspect or to have us copy for you. If you request a copy of the
records, the pharmacy may charge a fee for the cost of copying, mailing, or services
associated with your request. In certain very limited circumstances, the law
provides that the pharmacy may deny your request to inspect or copy these records. If you
are denied access to health information, you may request that the denial be
reviethe pharmacyd by a licensed health care professional chosen by us who did not
participate in the original decision to deny your access to review your request
and the reasons for the denial.
D.
your Right to Request an Amendment to your Health
Information. If you believe the
health information within your medical record is incorrect, you may ask us to
amend the information. Please submit such requests in writing by e-mail or
U.S. mail to their Privacy Officer at
the address listed below, and include the requested amendment along with a
reason you believe your health information should be amended. the pharmacy are not
required, however, to honor your request if the pharmacy did not create the information
you are requesting be amended or if the information in your record is correct.
the pharmacy will respond to your request in writing within 60 days of the date of receipt
of your written request for amendment of your information, unless the pharmacy advise you
the pharmacy require an additional 30 days.
E.
Right to an Accounting of Disclosures. You have the right
to request a list accounting for any disclosures of your protected health
information the pharmacy have made, except for uses and disclosures for a) treatment,
payment, and health care operations, b) disclosures to you, c) disclosures
pursuant to your authorization, and d) disclosures for certain other limited
reasons specified by law. To request a list of disclosures, please contact their
Privacy Officer by e-mail or
U.S. mail at the address listed
below, and obtain their "Request for an Accounting of Disclosures of Protected
Health Information" form, and submit the completed form to the Privacy Officer.
your request must state a time period which may not be longer than six years,
and may not include dates before
April 14, 2003. The first list you request within a 12
month period will be free. For additional lists, the pharmacy may charge you for the costs
of providing the list. the pharmacy will mail you a list of disclosures within 60 days of
your request, unless the pharmacy advise you the pharmacy require a period of up to an additional 30
days to comply with your request.
F.
Right to a Paper Copy of this Notice. You have the right
to obtain a paper copy of this notice at any time. To obtain a paper copy,
please request it from their Privacy Officer at the address listed below. You may
also view and print a copy of their Notice of Privacy Practices at http://www.Pharmacy Medications
G.
Effective Date. This revised Notice
of Privacy Practices is effective on
January 1, 2004, and pertains to all protected health
information the pharmacy maintain.
H.
Changes to this Notice. the pharmacy reserve the right
to change this notice, and the pharmacy may make the revised or changed notice effective
for all protected health information the pharmacy already have about you as well as any
information the pharmacy receive in the future. the pharmacy will post a copy of the current notice
on their the pharmacybsite. The notice will contain an effective date. In addition, each
time you request products from us, their current Notice of Privacy Practices will
be available to you. their current Notice of Privacy Practices may be viethe pharmacyd on
the Pharmacy Medications the pharmacybsite or this the pharmacybsite, and may be obtained by
requesting it by telephone, by e-mail, or in writing from their Privacy
Officer.
I.
Complaints. the pharmacy are committed to
safeguarding your protected health information. Despite their good faith efforts,
questions, concerns, mistakes, and misunderstandings may arise. If you have a
concern or believe that the pharmacy may have violated your privacy rights, the pharmacy enctheirage
you to bring that to their attention.
You may
bring any complaints or concerns regarding your privacy rights to their attention
by calling 1-800-409-5388 and requesting to speak with their Privacy Officer or
their authorized representative. If you prefer, you may submit a complaint in
writing to their Privacy Officer Privacy@Pharmacy Medications.
You also may complain to the Secretary of the Department of Health and Human
Services or his or her authorized representative if you believe your privacy
rights have been violated.
the pharmacy take all
concerns and complaints very seriously and will investigate each one promptly.
If the pharmacy made a mistake, the pharmacy will do what the pharmacy can to correct it and take steps to
prevent mistakes in the future. Under no circumstances will the pharmacy retaliate against
you for expressing a concern or filing a complaint relating to your privacy
rights.
J.
Privacy Officer and Privacy Contact Person. If you have any
questions about this notice or wish to exercise any of your privacy rights,
please contact Pharmacy Medications's Privacy Officer, or their authorized
representative, by e-mail to Privacy@Pharmacy Medications.
K. Acknowledgment of
Receipt of this Notice. the pharmacy will request you
electronically acknowledge you have received a copy of this notice when you
first request the pharmacy provide services to you by checking a box acknowledging your
receipt of this Notice of Privacy Practices. Please check this box only if you
have received this Notice.
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