This notice describes how medical information about you may be used
and disclosed and how you can get access to this information.

At Haggen Food and Pharmacy, we value your trust and confidence in our ability to protect your important personal information. We are committed to safeguarding the privacy of your protected health information (PHI). PHI is information that may identify you and relates to your past, present or future physical or mental health or condition and related health care services.

This notice describes how we will use and disclose your PHI, your health information rights, and our legal duties to safeguard your PHI.

• We will use PHI for treatment. Example: Information obtained by the pharmacist will be used to dispense medication to you.
• We will use PHI for payment. Example: We will communicate with your insurer to determine whether it will pay for your prescription.
• We will use PHI for health care operations. Example: We may use information in your health record to improve the quality of health care and service we provide.
• We may disclose PHI to Business Associates acting on our behalf to Assist us in conducting our business. A company that processes your prescription claims is our business associate. It must comply with all of the privacy regulations on our behalf.
• We may disclose PHI about you without your authorization to comply with:
• Federal and State Government health care programs such as Medicare and Medicaid.
• Federal and State Government agencies such as the FDA and the DEA.
• Public health requirements.
• Workers compensation laws.
• Law enforcement requests.
• Legal proceedings.
• Health oversight activities.
• Other state and federal laws.

There are miscellaneous authorized disclosures of PHI, including requests from correctional institutions, research projects, organ transplant organizations, coroners, medical examiners and funeral directors. Additionally, we must comply with requests from authorized government officials if you are in the military or a veteran. We may disclose PHI for purposes of national security and intelligence, and for protection of the president.

We may disclose PHI about you when necessary to prevent a serious threat to public health and safety, or for your benefit in the case of an emergency. We may communicate with you concerning your health and treatment, including refill reminders, or to inform you of health-related services of benefit to you. We may communicate PHI to your personal representative or caregiver. We will infer that a person who states that they are picking up your prescription is acting as your caregiver, and that any person accompanying you when you pick up a prescription is authorized by you to overhear disclosures of your PHI.

We may disclose PHI about you to a government authority if we reasonably believe you are a victim of abuse, neglect, or domestic violence. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else.

• You may request access to your PHI - including a visual inspection of your records and/or copies of your records. Due to the proprietary nature of our computer software, direct access to our computers will not be permitted.
• You may request an amendment or correction of your PHI.
• You may request an accounting of non-routine disclosures of your PHI – remember that some disclosures are exempt from this requirement, including disclosures made: for treatment, payment and health care operations, directly to you, pursuant to an authorization granted by you, to persons involved in your care, prior to April 14, 2003, or as otherwise permitted by law.
• You may request that we restrict uses and disclosures of your PHI.
• You may request that we contact you at alternative locations or by alternative means.

If you would like more information, or further explanation, please contact the Privacy Officer of Haggen Food and Pharmacy at the address or telephone number provided at the end of this Notice. All requests to access, amend, correct, account for non-routine disclosures, or restrict your PHI must be submitted to our Privacy Officer, using forms, available to you at any of our pharmacies. If we are unable to provide our records we will provide a written explanation of why we are not able to provide the records. Depending on the reason, you may submit a written request for us to reconsider. We may charge a reasonable fee for copying, including the labor cost of copying, and any expense for mailing and preparing a summary report for you.

In addition, we will accommodate your written request for a copy of your patient profile or for confidential communication at an alternate address or phone number. These requests may be made at the pharmacy. We will update your patient or insurance information upon request at the pharmacy.

Haggen Food and Pharmacy is required to follow the terms of this Notice, to provide this Notice to you, and to request your acknowledgment (signature) that it has been provided to you. We are able to provide services to you even if you do not sign the acknowledgment of the receipt of this Notice or if we decide not to honor a request regarding the information in this document.

We will not use or disclose PHI about you without written authorization, except as described in this Notice. You may revoke any authorization in writing at any time. We reserve the right to change our practices and this Notice, and to make the new Notice effective for all PHI we maintain. Upon request we will provide any revised Notice to you.

You may submit a complaint if you believe that we have violated your rights as described above, and fear adverse action by us against you for exercising your right. You can file the complaint with us directly. Our Haggen Food and Pharmacy staff will help you route your complaint to our Privacy Officer. You may also file your complaint with the United States Department of Health and Human Services. Please be assured that we will work with you to resolve any complaint, including providing you with the address for filing a complaint with HHS.

If you have any questions about our Notice of Privacy Practices, or for more information, please contact the office of:

Haggen Food and Pharmacy Privacy Officer
PO Box 9704
Bellingham, WA 98227
Phone: (360)-752-6421