Effective Date: [01/01/2025]

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.

Our Commitment to Your Privacy

At Choice Pharmacy, we are committed to maintaining the privacy of your protected health information (PHI) and providing you with a notice of our legal duties and privacy practices concerning your health information. We are required by law to maintain the privacy of your PHI and to provide you with a copy of this notice detailing our legal obligations and privacy practices.

How We May Use and Disclose Your Health Information

The following categories describe how we may use and disclose your PHI for various purposes:

1. Treatment

   We may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services. This includes sharing information with doctors, nurses, and other healthcare providers involved in your care.

2. Payment

   We may use and disclose your PHI to obtain payment for the medications and services provided to you. This may involve communicating with health insurance companies, pharmacies, and other healthcare providers to determine your eligibility for benefits or to bill for services rendered.

3. Healthcare Operations

   We may use and disclose your PHI for pharmacy operations, such as evaluating the quality of our services, conducting audits, or training pharmacy staff.

4. Appointment Reminders and Refill Notifications

   We may use your PHI to remind you of upcoming appointments, prescription refills, or to inform you of other pharmacy-related matters.

5. As Required by Law

   We may disclose your PHI when required to do so by federal, state, or local law.

6. Public Health Activities

   We may disclose your PHI to public health authorities for purposes such as reporting adverse reactions to medications, coordinating public health activities, or preventing disease outbreaks.

7. Health Oversight Activities

   We may disclose your PHI to health oversight agencies for activities authorized by law, including audits, inspections, investigations, and licensing.

8. Legal Proceedings

   We may disclose your PHI in response to a court order or subpoena, in the course of litigation, or to comply with applicable legal processes.

9. Law Enforcement

   We may disclose your PHI to law enforcement authorities for purposes such as identifying or locating a suspect, victim, or missing person.

10. Research

    We may use or disclose your PHI for research purposes, subject to strict privacy protections and approval by an institutional review board.

11. In Cases of Emergency

    We may use or disclose your PHI in situations where you are unable to consent, such as during an emergency medical situation.

Your Rights Regarding Your Health Information

You have the following rights regarding your PHI:

• Right to Inspect and Copy

  You have the right to inspect and copy your PHI. Requests for access to records must be made in writing. We may charge a reasonable fee for copying and mailing the records.

• Right to Request Corrections

  If you believe that your PHI is incorrect or incomplete, you have the right to request that we correct or update it.

• Right to an Accounting of Disclosures

  You have the right to request an accounting of certain disclosures of your PHI made by us.

• Right to Request Restrictions

  You have the right to request restrictions on certain uses and disclosures of your PHI. While we are not required to agree to all requests, we will consider them and inform you of our decision.

• Right to Confidential Communications

  You have the right to request that we communicate with you about your PHI in a specific way or at a specific location (e.g., by phone or mail).

• Right to a Copy of This Notice

  You have the right to receive a copy of this Notice at any time, even if you have agreed to receive it electronically.

Changes to This Notice

We reserve the right to revise this Notice of Privacy Practices at any time. Any changes will apply to the information we already have about you as well as any information we receive in the future. We will post the new Notice in our pharmacy and provide a copy to you upon request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services (HHS). To file a complaint with us, please contact [Pharmacy Contact Information]. You will not be penalized for filing a complaint.

Contact Information

If you have any questions about this Notice or need more information, please contact:

• Choice Pharmacy
• 9151 Reisterstown Rd. Owings Mills, MD 21117
• 410-363-8222