PRIVACY POLICY

Putvin Drug Store
NOTICE OF PRIVACY PRACTICES
Effective June 3, 2013

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.

As part of the federal Health Insurance Portability and Accountability Act of 1996, know as HIPAA, the healtcare provider has
created thisw Notice of Privacy Practices (Notice). This notice describes the healtcare providers's privacy practices and the
rights you, the individual, have as they relate to the privacy of hyour Protected Health Information (PHI). Your PHI is information about you, or that could be used to identify you, as it relates to your pact and present physical and mental health
care services. The HIPPA regulations require that the healthcare provider protect the privacy of your PHI that the healthcare
provider has received or created.

This healthcare provider will abide by the terms presented within this Notice. For any uses or disclosures that are not listed
below, the healthcare provider will obtain a written authorization from you for that use or disclosure, which you will have the
right to revoke at any time, as explained in more detail below. The healthcare provider reserves the right to change the
healthcare provider's privacy practices and this Notice. Revisions to the Notice will be posted in the healthcare provider and
upon request, provided to you in a paper format.