
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.
BlendRx Inc. ("BlendRx") is a licensed compounding pharmacy in California. We are required by federal and California law to maintain the privacy of your Protected Health Information (PHI), provide you this Notice of our legal duties and privacy practices, and inform you of your rights under the Health Insurance Portability and Accountability Act (HIPAA) and California's Confidentiality of Medical Information Act (CMIA).
Protected Health Information (PHI) includes information that can identify you and that relates to your past, present, or future physical or mental health condition, treatment, or payment for health care.
How We May Use and Disclose Your PHI Without Authorization
We are permitted to use or disclose your PHI for:
We may use your PHI to fill your prescriptions and coordinate care with your physician or veterinarian.
We may use your PHI to process insurance claims, billing, or collect payment for our services.
We may use PHI for pharmacy management, staff training, quality assurance, licensing compliance, or
audits.
We may disclose PHI to government agencies to prevent or control disease, support recalls, report abuse or neglect, or reduce serious threats to health or safety.
We may disclose PHI to the California Board of Pharmacy or federal health oversight agencies for inspections, investigations, or audits.
We may share your PHI in response to a court order, subpoena, or other lawful process.
We may disclose PHI as required by law or for law enforcement investigations.
We may share PHI for identification, cause of death determinations, or funeral arrangements.
If you are incarcerated, we may disclose your PHI to the institution for your health or safety.
We may use PHI for approved research under strict privacy safeguards.
Disclosures may be made to authorized officials for national defense or disaster response.
Uses That Require Your Written Authorization
We will not use or disclose your PHI for:
- Marketing purposes
- Sale of your information
- Other purposes not described in this notice
...unless you sign a written authorization. You may revoke that authorization in writing at any time. Your Rights Regarding Your PHI
You may request to inspect or get a copy of your PHI, including prescription, billing, and case management records.
You may request we correct information you believe is incomplete or incorrect.
You may request a list of certain disclosures made of your PHI, excluding treatment, payment, and operations.
You may ask us to limit how your PHI is used or disclosed. We may not be able to agree to all requests.
You may request that we contact you in a specific way or at a specific location for your privacy.
You may request a printed copy of this notice at any time.
BlendRx employees are trained in privacy and must follow our physical, technical, and administrative safeguards. Only authorized personnel may access your PHI.
Changes to This Notice
We may update this Notice as laws or policies change. The updated Notice will apply to all PHI we maintain and will be posted on our website or available upon request.
Questions or Complaints
If you believe your privacy rights have been violated, you may submit a written complaint to us or the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
4128 W. Burbank Blvd.
Burbank, CA 91505
Email: info@blend-rx.com
Phone: (818) 697-0058
Fax: (818) 697-6785