Simpson's Pharmacy Notice of Privacy Practices Summary

(A full copy of our Policy is Available in our store)

All of us at Simpson's Pharmacy value your relationship with us, and we know that respect for your privacy is the foundation of that relationship. We are committed to protecting the privacy of your protected health information (PHI) that is in our possession and only using and disclosing your PHI as necessary to providing you with health care products and services. PHI is any information that we possess, use, and disclose that identifies you and relates to your past, current, or future physical and mental health condition or illness and the health care products and services that have been provided to you.

This information sheet is a summary only. You have the right to receive the complete written Notice of Privacy Practices describing in detail how we will protect your PHI and your rights related to PHI. You may request this written notice at any time.

Our responsibilities
Simpson's Pharmacy is required by law to:

Ø Maintain the privacy of your health information
Ø Provide a notice of Privacy Practices explaining our duties and privacy practices
Ø Abide by the terms of the notice currently in effect

We reserve the right to change privacy practices, and to make the new practices applicable to all information we maintain.

Your rights

You have the right to:

Ø Request a limitation on our use and disclosure your personal health information (We may not be able to comply with all requests)
Ø In writing, request to inspect and copy your medical information (fees may apply)
Ø In writing, request changes in the content of your PHI contained in our records where you believe the content is incomplete, inaccurate, or for some other reason needs to be changed (We may not be able to comply with all requests)
Ø Request that we communicate with you about your PHI in a confidential manner and only to locations or by means specified by you (such as a specific phone number or address)
Ø In writing, request an accounting (written record) of how your PHI was disclosed (excludes disclosures for purposes of treatments, payment or health care operations.
Ø File a complaint if you believe that we have violated your rights as described above, and to not fear retaliation or adverse action by us against you for exercising your right.

How do we use your personal health information?

When you visit Simpsonxs Pharmacy, we use your personal health information to treat, to obtain payment for services, and to conduct health care operations. Examples of how we use your information include:


As a pharmacy, we may use and disclose your PHI as necessary to maintain a patient profile on you, which may include information about you; your medical condition, medications, and prescription devices that you use; any allergies that you may have; and other information, such as health insurance that you may have.


We document the services and supplies you receive at each visit so that you, your insurance company or another third party can pay us.

Health Care Operations

Activities that are necessary and related to our providing of health care products and services to you such as conducting quality assessment and improvement activities.

Business Associates

We may not be able to provide health care products and services to you without the involvement of other businesses or persons. One of our most common business associates is a health insurance company or a company that processes claims that we submit for payment for health care products and services that we provide you.

Information we may share

There are other times when we are permitted or required to disclose medical information without your signed permission. Examples of these situations are to protect victims of abuse or neglect, to avert serious threat to public health or safety, legal disputes or workers compensation. Please refer to the Simpsonxs Pharmacy Notice of Privacy Practices for a detailed list of these situations. Any other use or disclosure may only be done with your signed authorization. You may revoke your authorization at any time by contacting the provider who obtained your original authorization.

Need more information?

-Write to our Privacy Officer at:
10 Newport Avenue
Pawtucket, RI 02861

-Or, call the Privacy Officer at 401-722-7600

All complaints will be thoroughly investigated, and you will not suffer retaliation for filing a complaint. You may also file a complaint with the Office of Civil Rights in Washington, D.C.
phone: 401-722-7600