Uses and disclosures of PHI for Payment: The pharmacy will disclose your PHI to obtain payment or reimbursement form insurers for your health care services. Uses and disclosures of PHI for Treatment: We will use the PHI that we receive from you to fill your prescription and coordinate or manage your health care. HOW THE PHARMACY MAY USE AND DISCLOSE YOUR PHI The following is an accounting of the ways that the pharmacy is permitted, by law, to use and disclose your PHI. Revisions to the Notice will be posted in the pharmacy and upon your request, provided to you in a paper format. The pharmacy reserves the right to change the pharmacy's privacy practices and this Notice. For any uses or disclosures that are not listed below, the pharmacy will obtain a written authorization from you for that use or disclosure, which you will have the right to revoke at any time, as explained in more detail below. This pharmacy will abide by the terms presented within this Notice. The HIPAA regulations require that the pharmacy protect the privacy of your PHI that the pharmacy has received or created. Your PHI is information about you, or that could be used to identify you, as it relates to your past and present physical and mental health care services. This Notice describes the pharmacy's private practices and the rights you, the individual, have as they relate to the privacy of your Protected Health Information (PHI). As part of the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, the pharmacy has created this Notice of Privacy Practices (Notice).

NOTICE OF PRIVACY PRACTICES Effective ApTHIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

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