HIPAA Privacy Statement for Memorial Rx Pharmacy Website
Effective Date: May 15, 2026
Last Updated: May 15, 2026
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
Memorial Rx Pharmacy is committed to protecting the privacy of your personal health information (PHI). This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, or healthcare operations, and for other purposes permitted or required by law. It also describes your rights to access and control your protected health information.
We are required by law to:
-
Maintain the privacy of your protected health information
-
Provide you with this notice of our legal duties and privacy practices
-
Follow the terms of the notice currently in effect
-
Notify you if we are unable to agree to a requested restriction
-
Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations
How We May Use and Disclose Your Health Information
1. Treatment
We may use and disclose your health information to provide, coordinate, or manage your healthcare and related services. This includes consultation with other healthcare providers regarding your treatment and referrals to other providers.
2. Payment
We may use and disclose your health information to obtain payment for services we provide. This includes billing your insurance company and obtaining prior authorization for medications.
3. Healthcare Operations
We may use and disclose your health information for our healthcare operations, including quality assessment, employee review, training, licensing, and conducting or arranging for other business activities.
4. Business Associates
We may disclose your health information to third-party service providers (business associates) who perform services on our behalf. These business associates are required by contract to safeguard your information.
5. Pharmacy Benefits
We may disclose your health information to health plan sponsors to permit them to administer benefits under their pharmacy benefit plans.
6. Required by Law
We may use or disclose your health information when required to do so by federal, state, or local law.
7. Public Health Activities
We may disclose your health information for public health activities, including reporting adverse drug reactions, product recalls, disease prevention, or disease tracking.
8. Health Oversight Activities
We may disclose your health information to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, and licensure.
9. Legal Proceedings
We may disclose your health information in response to a court or administrative order, subpoena, discovery request, or other lawful process.
10. Law Enforcement
We may disclose your health information to law enforcement officials for law enforcement purposes as required by law or in compliance with a court order or subpoena.
11. Deceased Individuals
We may disclose health information about deceased individuals to coroners, medical examiners, or funeral directors as necessary to carry out their duties.
12. Organ and Tissue Donation
We may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for donation and transplant purposes.
13. Research
Under certain circumstances, we may use and disclose your health information for research purposes with your authorization or when an institutional review board has reviewed the research proposal.
14. Serious Threat to Health or Safety
We may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
15. Specialized Government Functions
We may use or disclose your health information for military, national security, correctional institution, or other specialized government functions as authorized by law.
16. Workers' Compensation
We may disclose your health information as authorized by and to the extent necessary to comply with workers' compensation laws.
17. Marketing and Sale of Information
We will not use or disclose your health information for marketing purposes or sell your health information without your written authorization. You may revoke such authorization at any time.
18. Immunization Records to Schools
We may disclose proof of immunization to a school where state law requires the school to have such information prior to admitting a student, if you have agreed to the disclosure orally or in writing.
Your Rights Regarding Your Health Information
1. Right to Inspect and Copy
You have the right to inspect and obtain a copy of your health information maintained in our records. To inspect or copy your health information, submit a written request to our Privacy Officer. We may charge a reasonable fee for copying and mailing costs.
2. Right to Amend
If you believe that information in your record is incorrect or incomplete, you may request that we amend it. Your request must be in writing and provide a reason for the amendment. We may deny your request under certain circumstances.
3. Right to an Accounting of Disclosures
You have the right to request an accounting of certain disclosures of your health information made by us during the six years prior to your request. The accounting will not include disclosures made for treatment, payment, healthcare operations, or disclosures made to you or authorized by you.
4. Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of your health information. We are not required to agree to your request except in certain circumstances, such as when you have paid out-of-pocket in full for a service and request we not disclose information about that service to your health plan.
5. Right to Request Confidential Communications
You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may request that we contact you only at work or by mail. We will accommodate reasonable requests.
6. Right to a Paper Copy of This Notice
You have the right to obtain a paper copy of this notice at any time, even if you have agreed to receive it electronically. You may request a copy from our pharmacy staff or download it from our website.
7. Right to Be Notified of a Breach
You have the right to be notified if there is a breach of your unsecured protected health information.
Changes to This Notice
We reserve the right to change this notice and 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. We will post a copy of the current notice in our pharmacy and on our website. The notice will contain the effective date on the first page.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our pharmacy or with the Secretary of the Department of Health and Human Services. To file a complaint with us, contact our Privacy Officer at the address below. All complaints must be submitted in writing. You will not be penalized or retaliated against for filing a complaint.
Contact Information
Privacy Officer:
Memorial Rx Pharmacy
8488 W. Hillsborough Ave
Tampa, FL 33626
Phone: 813-800-4455
Email: privacy@memorialrx.com
Office for Civil Rights:
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
Acknowledgment
By using our pharmacy services, you acknowledge that you have been provided with a copy of this Notice of Privacy Practices and have had an opportunity to review it.
