HIPPA

Alberty Drugs, 81 Main St., Batavia, NY 14020
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. Date of Notice 4-01-2003.

Section A: Uses and Disclosures of Protected Health Information

#1 Under applicable law, we are required to protect the privacy of your individual health information (information we refer to in this notice as "Protected Health Information", herein after referred to as PHI. We are also required to provide you with this Notice regarding our policies and procedures regarding your PHI and to abide by the terms of this notice, as it maybe be updated from time to time.
    We are permitted to make certain types of uses and disclosures under the applicable law for treatment, payment, and healthcare operations purposes. We may obtain information to dispense prescriptions and for the documentation of pertinent information in your records that may assist us in managing your medication therapy or your overall health. For treatment purposes, such use and disclosure will take place in providing, coordinating, or managing healthcare, and its related services by one or more of your providers, such as when your pharmacist consults your physician or a specialist regarding your medications, treatment, or condition.
    For payment purposes, such use and disclosure will take place in a number of ways, including for quality assessment and improvement; provider review and training; underwriting activities; and planning development, management and administration. Your information could be used, for example to assist in the evaluation of the quality care that you were provided.
    We store some of your PHI in electronic computer files. We backup our electronic records daily and employ other precautions to safeguard the integrity of your PHI. In spite of these precautions it is possible but unlikely that a computer crash or other technological failure could cause the loss of data. In addition reasonable safeguards are employed to protect your PHI stored on electronic media.
    In addition, we may contact you to provide refill reminders, health screenings, wellness events, inoculations, vaccinations or information about treatment alternative or health-related benefits and services that may be of interest to you. In addition, we disclose your health information to your plan sponsor.
    We may use and disclose your PHI, without your authorization when the pharmacy needs to contact a physician or physician's staff and is permitted or required to do so without individual written authorization. We may use and disclose your PHI if we are contacted by another pharmacy who states they have your request and consent to transfer pharmacy records to them.
    From time to time we may employ the services of business associates who may assist us in one or more tasks and who may use, change or create PHI. Business associates are required to comply with all the privacy regulations on your behalf.
    We may disclose PHI about you without your written authorization to comply with workers compensation laws, as required by law enforcement, legal proceedings, public health requirements, health oversight activates and as required by law.
    Other uses and disclosures will be made only with your written authorization, and you may revoke your authorization by notifying us as described in Section B.

Section B:

#2 You may ask us to restrict uses and disclosures of your PHI to carry out treatment, payment, or healthcare operations, or to restrict uses and disclosures to family members, relatives, friends, or other persons identified by you who are involved in your care or payment for your care. However, we are not required to agree with your request.
#3 You have the right to request the following with respect to your PHI: (1) inspection and copying; (2) amendment or correction; (3) an accounting of the disclosures of the information by us (we are not required to account to you for disclosures made for treatment, payment, operations, disclosures to you, disclosures to your caregivers, for notification or as otherwise excluded by law); and (4) the right to receive a paper copy of this notice upon request. We may require you to pay for this request to cover our costs of copying, labor, and postage.
    In addition you may request and we must accommodate the request, if reasonable, to receive communications of PHI by alternative means or at alternative locations, to make this request please contact, in writing:

Alberty Drugs, 81 Main St., Batavia, NY 14020 Attention: Paul Gluck

#4 We may use your name to reference your prescriptions and pharmaceutical care service. You may be required to sign a signature log form to acknowledge receipt of service, to acknowledge receipt of this Notice and disclosure of PHI as outlined herein. This information may be disclosed by us to other persons who ask for you or your prescriptions by name. You may restrict or prohibit these uses and disclosures by notifying a pharmacy representative orally or in writing of your restriction or prohibition. We are not required to honor these requests. We are able to provide treatment services to you even if you object to sign the acknowledgement of the receipt of the Notice or if we decide not to honor a request regarding the information in this document. In the event of an emergency or your incapacity, we will do in our reasonable judgment what is consistent with your known preference and what we determine to be in your best interest. We will inform you of any such uses or disclosures if uses and disclosures would require your signed authorization under such circumstances and give you an opportunity to object as soon as practicable.
#5 We may disclose to one of your family members, to a relative, to a close personal friend, or to any other person identified by your PHI that is directly relevant to the person's involvement with your care or payment related to your care. In addition we may use or disclose the PHI to notify, identify, or locate a member of your family, your personal representative, another person responsible for you care, or certain disaster relief agencies in your location, general condition, or death. In you are incapacitated, there is an emergency, or you object to this use or disclosure and will disclose only the information that is directly relevant to the person's involvement with your healthcare. We will also use our judgment and experience regarding your best interest in allowing people to pick up filled prescriptions, or other similar forms of PHI.
#6 We reserve the right to change the terms of this Notice provisions effective for all PHI we maintain. You may receive a copy of this Notice by contacting us as outlined in Section B or upon receipt of pharmacy care services.
#7 If you believe that your privacy rights have been violated, you may complain to us at the location described in Section B or the Secretary of the Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue SW, Washington, DC 20201. You will not be retaliated against for filing a complaint.

Section B: Contacting Us:
For further information, contact us at (585-344-1570 or by mail at:
Alberty Drugs, 81 Main St., Batavia, Ny 14020 Attention: Paul Gluck