Our Privacy Practices
20005 Katy Fwy.
Katy, Texas - 77450
NOTICE OF PRIVACY PRACTICES
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
The Pharmacy is required to maintain the privacy of your Protected Health
Information ("PHI") and to provide you with a notice of our legal duties and
privacy practices with respect to PHI. PHI is information about you, including
basic demographic information, that may identify you and that relates to your
past, present or future physical or mental health or condition and related
health care services. This Notice of Privacy Practices ("Notice") describes how
we may use and disclose PHI about you to carry out treatment, payment or health
care operations and for other specified purposes that are permitted or required
by law. The Notice also describes your rights with respect to PHI about you.
The Pharmacy is required to follow the terms of this Notice. We will not use or
disclose PHI about you without your written authorization, except as described
in this Notice. We reserve the right to change our practices and this Notice and
to make the new Notice effective for PHI we maintain. Upon request, we will
provide a revised Notice to you.
Your Health Information Rights
You have the following rights with respect to PHI about you:
· Obtain a paper copy of the Notice upon request. You may request a copy
of the Notice at any time. Even if you have agreed to receive the Notice
electronically, you are still entitled to a paper copy. To obtain a paper copy,
contact the "Privacy Officer" whose name appears at the end of this notice.
· Request a restriction on certain uses and disclosures of PHI. You have
the right to request additional restrictions on our use or disclosure of PHI
about you by sending a written request to the "Privacy Officer" whose name
appears at the end of this notice. We are not required to agree to those
· Inspect and obtain a copy of PHI. You have the right to access and
copy PHI about you contained in a designated record set for as long as the
Pharmacy maintains the PHI. The "designated record set" usually will include
prescription and billing records. To inspect or copy PHI about you, you must
send a written request to the "Privacy Officer" whose name appears at the end of
this notice. We may charge you a fee for the costs of copying, mailing, or other
supplies that are necessary to fulfill your request. We may deny your request to
inspect and copy in certain limited circumstances. If you are denied access to
PHI about you, you may request that the denial be reviewed.
· Request an amendment of PHI. If you feel that PHI we maintain about
you is incomplete or incorrect, you may request that we amend it. You may
request an amendment for as long as we maintain the PHI. To request an
amendment, you must send a written request to the "Privacy Officer" whose name
appears at the end of this notice. You must include a reason that supports your
request. In certain cases, we may deny your request for amendment. If we deny
your request for amendment, you have the right to file a statement of
disagreement with the decision and we give a rebuttal to your statement.
· Receive an accounting of disclosures of PHI. You have the right to
receive an accounting of the disclosures we have made of PHI about you after
April 14, 2003
This notice is effective as of 7/26/2011_ (the Publication date of the notice).
Privacy Officer :
Pharmacy: Katy Pharmacy
System Time: 5/27/2022 12:55:48 AM PST