Privacy Policy
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.
Examples of disclosures for Treatment, Payment and Health Operations:
- We will use your health information for treatment. For example: We will provide information to you health care professional to assist them in treatment decisions or to obtain refill authorizations.
- We will use your health information for payment. For example: We submit prescriptions claims electronically to obtain payment from your insurance carrier.
- We will allow a member of your family to pick up a prescription for you, unless you instruct us not to do so.
- We will provide family members and caregivers with information about your medications in order to assist with your care.
- We may contact you with refill reminders
- We may contact you to provide general health information.
Other disclosures permitted without authorization
We will:
- Provide your PHI to public health authority authorized by law to prevent or control disease; investigate child abuse or neglect, or a person subject to the jurisdiction of the Food and Drug Administration (FDA).
- Use your information to report adverse events to drug manufacturers or the FDA.
- Use your information to facilitate drug product recalls.
- Use your information to comply with post-marketing surveillance by drug manufacturers
Without your written authorization, we will NOT:
- Disclose information for purposes other than treatment, payment or health care operations.
- Sell your information to anyone for marketing purposes.
Your Health Information Rights
You have the right to:
- Restrict certain uses and disclosures of your information.
- Inspect and copy your records
- Request an amendment to your health record
- Request accounting of disclosures containing your PHI.
- Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
- Obtain a paper copy of this notice of health information by alternative means at alternative locations
Our Responsibilities
- Maintain the privacy of your health information.
- Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
- Abide by the terms of this notice, and notify you if we are unable to agree to a requested restriction.
- Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
For more information or to report a problem:
If you have a question and would like additional information, you may contact Larry Macklin at 847-480-1000. If you believe your privacy rights have been violated, you may file a complaint with Service Excellence or with the secretary of Health and Humans Services.
I acknowledge and I understand my privacy rights as a patient of Dundee Pharmacy
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