• For Treatment: Information obtained by the pharmacy will be used to dispense your prescriptions to you. We may disclose health information about you to pharmacists and other persons who are involved in dispensing your prescription.
• For Payment: We may use and disclose your health information so that your pharmacy services may be billed to, and payment may be collection from, you, an insurance company or a third party.
• For Health Care Operations: We may use and disclose health information about you for pharmacy operations. Unless you provide us with alternative instructions, we may send refill reminder and other materials related to your health care to your home. These uses and disclosures are necessary to run the Pharmacy and make sure that you receive quality customer service.
• As Required by Law: We will disclose health information about you when required top do so by federal, state or local law.
• To Avert a Serious Threat to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
• Public Health Risks: We may disclose health information about you for public health activities. These activities generally include the follow: (1) to prevent or control disease, injury or disability; (2) to report reactions to medications or problems with products; (3) to notify people of recalls of products they may be using; (4) to notify a personal who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and (5) to notify the appropriate government authority if we believe a person has been the victim of abuse, neglect, or domestic violence (we will only make this disclosure if you agree or when required by or authorized by law).
• For Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities, which are necessary for the government to monitor the health care system, include audits, investigations, inspections and licensure.
• Lawsuits and Disputes: If you are involved in a lawsuit or dispute, we may disclose health information about you in response to a court order or administrative order. We may also disclose health information about you in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request (which may include written notices to you) or to obtain an order protecting the information requested.
• For Specific Government Functions: Hudson Pharmacy may disclose health information for the following specific government functions: (1) health information of military personnel, as required by military command authorities; (2) health information of inmates, to a corrections institution or law enforcement officer (3) in response to a request form law enforcement, if certain conditions are satisfied; and (4) for national security reasons.

When Hudson Pharmacy May Not Use or Disclose Your Health Information

except as described in this Notice, Hudson Pharmacy will not use or disclose your health information without your written authorization. If you do authorize Hudson Pharmacy to use or disclose your health formation for another purpose, you may revoke your authorization in writing at any time.

You Have the Following Rights With Respect you Your Health Information.

• You have the right to request restrictions on certain uses and disclosures of your health information. Hudson Pharmacy is not required to agree to a restricting that you request. If we do agree to any restrictions, we will put the agreement in writing and follow it, except in emergency situations. We cannot agree to limit the uses or disclosures of information that are required by law.
• You have the right to inspect and copy your health information as long as the Pharmacy maintains the health information. Your health information usually will include prescription and billing records. To inspect or copy your health information, you must submit a written request to the store that provided your services. We may charge you a fee for the costs of copying, mailing or other supplies that are necessary to grant your request.
• You have the right to request that Hudson Pharmacy amend your health information that is incorrect or incomplete. To request an amendment, you must submit a written request to the pharmacy (form available from your pharmacist), along with the reason for the request. Hudson Pharmacy is not required to amend health information that is accurate and complete. We will provide you with information about the procedure for addressing any disagreement with a denial.
• You have a right to receive an accounting of disclosures of your health information we have made after April 14, 2003 for purposes other than disclosures (1) for our treatment, payment or health care operations, (2) to you or based upon your authorization and (3) for certain government functions. To request an accounting, you must submit a written request to the store providing services. You must specify the time period, which may not be longer than six years.
• You may request communications of your health information by alternative means or at alternative locations. For example, you may request that we contact you about health matters only in writing or at a different residence or post office box. To request confidential communication of your health information, you must submit a written request to the store providing services. Tour request must state how or when you would like be contacted. We will accommodate all reasonable requests.

If you would like to exercise one or more of these rights, contact the store or submit a written request to Hudson Pharmacy HIPPA Privacy, 325 Railroad Street, Hudson, MI 49247

Changes to this Notice of Privacy Practices

Hudson Pharmacy reserved the right to change this Notice. We reserved the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. Any revised Notice will be posted in the Pharmacy. Upon request, we will provide a revised Notice to you.

For Information or to Report a Problem

If you have questions or would like additional information about the Hudson Pharmacy privacy practices, you may contact us by mail at Hudson Pharmacy HIPPA Privacy, 325 Railroad Street, Hudson, MI 49247 or phone 1-517-448-3111 or Fax to 1-517-448-5892. If you believe your privacy rights have been violated, you may file a complaint with the Compliance Office at the above address, or with the Secretary of health and Human Services. There will be no retaliation for filing a complaint.

Notice of Policy Receipt • Print a copy of this notice for your records