HIPAA NOTICE OF PRIVACY PRACTICES
HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date: July 14, 2026
Oak Lawn Pharmacy
Operated by Pride Pharmacy Carlisle LLC
[BEFORE PUBLICATION, INSERT THE EXACT FEDERALLY REQUIRED HEADER FROM 45 CFR 164.520(b)(1)(i) OR THE CURRENT HHS MODEL NOTICE.]
This Notice describes Oak Lawn Pharmacy’s privacy practices and the ways in which we may use and disclose protected health information about you. It also explains your rights and our legal responsibilities.
This Notice applies to Oak Lawn Pharmacy, its workforce, and pharmacy locations or services covered by this Notice.
YOUR RIGHTS
You have the right to:
- Inspect or obtain a paper or electronic copy of certain health information.
- Ask us to correct information you believe is incorrect or incomplete.
- Request confidential communications.
- Ask us to limit certain uses or disclosures.
- Request an accounting of certain disclosures.
- Obtain a paper copy of this Notice.
- Authorize another person to act for you.
- File a complaint without retaliation.
YOUR CHOICES
In certain situations, you may tell us your preferences regarding how we share information, including communications with family members, friends, caregivers, or others involved in your care.
OUR USES AND DISCLOSURES
We may use and disclose protected health information for treatment, payment, healthcare operations, and other purposes permitted or required by law.
- YOUR PRIVACY RIGHTS
Inspect or obtain a copy of your health information
You may ask to inspect or obtain an electronic or paper copy of health information maintained by Oak Lawn Pharmacy in a designated record set.
We may require that the request be submitted in writing and that your identity or authority be verified.
We will respond within the timeframe required by law. We may charge a reasonable, cost-based fee when permitted by law.
In limited circumstances, we may deny access. When applicable, we will explain the denial and any available review rights.
Ask us to correct your health information
You may ask us to amend health information that you believe is incorrect or incomplete.
We may require a written request explaining the requested amendment.
We may deny the request in circumstances permitted by law. If we deny the request, we will provide a written explanation and information about available rights.
Request confidential communications
You may ask us to contact you in a particular manner or at a particular location.
For example, you may request that we call a particular telephone number or send mail to another address.
We will accommodate reasonable requests as required by law.
Ask us to limit what we use or disclose
You may ask us not to use or disclose certain information for treatment, payment, or healthcare operations.
Except where required by law, we generally are not required to agree to a requested restriction. If we agree, we will comply with the restriction except when the information is needed for emergency treatment or another legally permitted exception applies.
When you pay in full out of pocket for a healthcare item or service, you may ask us not to disclose information about that item or service to a health plan for payment or healthcare operations. We will comply when required by law unless another law requires the disclosure.
Request an accounting of disclosures
You may request a list of certain disclosures of your protected health information made during the period permitted by law.
The accounting does not include every disclosure. For example, certain disclosures for treatment, payment, healthcare operations, or disclosures authorized by you may not be included.
We will provide one accounting during the applicable period without charge. A reasonable, cost-based fee may apply to additional requests when permitted by law.
Obtain a copy of this Notice
You may request a paper copy of this Notice at any time, including when you previously agreed to receive it electronically.
Choose someone to act for you
A legally authorized personal representative may exercise rights and make decisions concerning your protected health information.
We will verify the representative’s identity and authority before taking action.
File a complaint
You may complain to Oak Lawn Pharmacy or the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights have been violated.
Oak Lawn Pharmacy will not retaliate against you for filing a complaint, asking a question, or exercising a privacy right.
- YOUR CHOICES ABOUT CERTAIN DISCLOSURES
Family members, friends, caregivers, and others involved in your care
When appropriate, we may disclose relevant information to a family member, caregiver, personal representative, or another person involved in your care or payment for your care.
When you are available and able to make decisions, we may ask for your permission, provide an opportunity to object, or reasonably infer that you do not object.
When you are unavailable or unable to express a preference, we may disclose information when, using professional judgment, the disclosure is in your best interest and is permitted by law.
Disaster-relief situations
We may disclose limited information to an authorized disaster-relief organization to assist with notification or coordination when permitted by law.
Marketing
Most uses or disclosures of protected health information for marketing require your written authorization unless an exception applies.
Sale of protected health information
Oak Lawn Pharmacy does not sell protected health information. A disclosure that would legally constitute the sale of protected health information would require authorization unless an exception applies.
Fundraising
If Oak Lawn Pharmacy uses permitted information for fundraising communications, you will be given a clear opportunity to opt out of future fundraising communications.
- HOW WE MAY USE AND DISCLOSE YOUR INFORMATION
Treatment
We may use or disclose protected health information to provide, coordinate, or manage your pharmacy care.
Examples include:
- Filling or transferring a prescription.
- Contacting a prescriber about a prescription.
- Reviewing medication therapy or potential interactions.
- Counseling you about medication use.
- Coordinating delivery or adherence packaging.
- Communicating with another pharmacy or healthcare professional involved in your care.
Payment
We may use or disclose protected health information to bill and obtain payment.
Examples include:
- Submitting a claim to an insurer or pharmacy benefit manager.
- Determining coverage, copayments, deductibles, or eligibility.
- Obtaining prior authorization.
- Coordinating benefits.
- Correcting or reversing a claim.
- Collecting an amount legally owed.
Healthcare operations
We may use or disclose protected health information for pharmacy and healthcare operations.
Examples include:
- Quality assessment and improvement.
- Medication-safety review.
- Staff training.
- Accreditation.
- Auditing and compliance.
- Credentialing.
- Fraud prevention.
- Business planning.
- Complaint investigation.
- Legal and administrative services.
- Technology and security operations.
Business associates
We may disclose protected health information to vendors or contractors that perform services on our behalf when permitted by law.
When required, we enter into agreements requiring business associates to appropriately safeguard protected health information.
Public-health and safety activities
We may disclose protected health information for legally permitted public-health or safety activities, including:
- Preventing or controlling disease.
- Reporting adverse medication reactions.
- Supporting product recalls.
- Reporting suspected abuse, neglect, or domestic violence when authorized or required.
- Preventing or reducing a serious and imminent threat to health or safety.
- Complying with public-health reporting requirements.
Health oversight
We may disclose information to legally authorized oversight agencies for audits, inspections, investigations, licensure, accreditation, disciplinary actions, or other activities authorized by law.
Required by law
We may use or disclose protected health information when federal, state, or local law requires it.
Workers’ compensation
We may disclose information as authorized by and necessary to comply with workers’ compensation or similar programs.
Law-enforcement and legal proceedings
We may disclose information to law enforcement, courts, attorneys, or other parties when permitted or required by law, including in response to a valid court order, warrant, subpoena, administrative request, or other lawful process.
Additional legal protections may apply to particular categories of health information.
Coroners, medical examiners, and funeral directors
We may disclose information to a coroner, medical examiner, or funeral director when permitted by law.
Organ and tissue donation
We may disclose information to organizations involved in organ, eye, or tissue donation and transplantation when applicable and permitted by law.
Research
We may use or disclose information for research when the requirements of applicable privacy law have been satisfied.
Government functions
We may disclose information for legally authorized military, national-security, correctional, protective-service, or other special governmental functions.
- USES AND DISCLOSURES REQUIRING WRITTEN AUTHORIZATION
Uses or disclosures not described in this Notice will generally be made only with your written authorization.
A written authorization may be required for:
- Most marketing uses or disclosures.
- A sale of protected health information.
- Most uses or disclosures of psychotherapy notes, if Oak Lawn Pharmacy maintains any.
- Other uses or disclosures for which applicable law requires authorization.
You may revoke an authorization in writing at any time, except to the extent that Oak Lawn Pharmacy has already acted in reliance on it or another legal limitation applies.
- CERTAIN SUBSTANCE USE DISORDER RECORDS
To the extent Oak Lawn Pharmacy receives or maintains records protected by 42 CFR Part 2, those records may be subject to additional federal confidentiality protections.
Such records generally may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you without your written consent or an appropriate court order and required legal process, as provided by applicable law.
- OUR RESPONSIBILITIES
Oak Lawn Pharmacy is required by law to:
- Maintain the privacy and security of protected health information.
- Provide you with notice of its legal duties and privacy practices.
- Follow the terms of the Notice currently in effect.
- Notify affected individuals following a breach of unsecured protected health information when required by law.
- Provide access to this Notice upon request.
- Refrain from retaliating against a person for exercising privacy rights or filing a complaint.
We will not use or disclose protected health information in a manner inconsistent with this Notice unless permitted or required by law.
- CHANGES TO THIS NOTICE
Oak Lawn Pharmacy reserves the right to change the terms of this Notice and make the revised terms effective for all protected health information it maintains, including information created or received before the revision.
When the Notice is materially revised, the updated Notice will be:
- Available at the pharmacy.
- Available upon request.
- Posted on the pharmacy website.
- Distributed or communicated as otherwise required by law.
The Notice will identify its effective date.
- QUESTIONS OR COMPLAINTS TO OAK LAWN PHARMACY
Questions, requests, and privacy complaints may be directed to:
Privacy Officer: Daniel Hayek
Oak Lawn Pharmacy
Operated by Pride Pharmacy Carlisle LLC
4003 Lemmon Ave
Dallas, TX 75219
Phone: (214) 954-7389
Fax: (855) 716-7525
Privacy Email: [INSERT PRIVACY EMAIL]
Business Hours: [INSERT BUSINESS HOURS]
Do not include unnecessary prescription information, Social Security numbers, or payment-card information in an ordinary email.
- COMPLAINTS TO HHS OFFICE FOR CIVIL RIGHTS
You may also file a privacy complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, DC 20201
Telephone: 1-800-368-1019
TDD: 1-800-537-7697
Online Complaint Information:
https://www.hhs.gov/ocr/complaints/index.html
Oak Lawn Pharmacy will not retaliate against you for filing a complaint.