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.

The Pharmacy is required by law to maintain the privacy of Protected Health Information (“PHI”) and to provide individuals with notice of our legal duties and privacy practices with respect to PHI.  PHI is information that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.  This Notice of Privacy Practices (“Notice”) describes how we may use and disclose PHI to carry out treatment, payment or health care operations and for other specified purposes that are permitted or required by law.  The Notice also describes your rights with respect to PHI about you.

The Pharmacy is required to follow the terms of this Notice.  We will not use or disclose PHI about you without your written authorization, except as described in this Notice.  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.

 Your Health Information Rights

All requests mentioned below must be made in writing by completing the appropriate Reasor’s  Pharmacy’ Protected Health Information Request Form which can be obtained from any of our pharmacies or by contacting the Reasor’s  Pharmacy’ Privacy Officer (see corp. mailing info.).

You have the following rights with respect to PHI about you:

Obtain a paper copy of the Notice upon request.  You may request a copy of the Notice at any time.  Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy.  To obtain a paper copy, contact your Reasor’s Pharmacy.

Request a restriction on certain uses and disclosures of PHI.  You have the right to request additional restrictions on our use or disclosure of PHI about you by sending a written request to Reasor’s Pharmacy Privacy Officer.  We are not required to agree to those restrictions, except if the disclosure is for the purpose of carrying out payment or healthcare operations and is not required by law, or the PHI pertains to a healthcare item or service for which you (or other individual on your behalf) has paid out-of-pocket in full.

Inspect and obtain a copy of PHI.  You have the right to access and copy PHI about you contained in a designated record set for as long as the Pharmacy maintains the PHI.  The designated record set usually will include prescription and billing records.  To inspect or copy PHI about you, you must send a written request to the Reasor’s Pharmacy where your PHI resides.  We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill your request.  We may deny your request to inspect and copy in certain limited circumstances.  If you are denied access to PHI about you, you may request that the denial be reviewed.  You may also request an electronic copy of your PHI.

Request an amendment of PHI.  If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it.  You may request an amendment for as long as we maintain the PHI.  To request an amendment, you must send a written request to Reasor’s Pharmacy’ Privacy Officer.  You must include a reason that supports your request.  In certain cases, we may deny your request for amendment.  If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may give a rebuttal to your statement.

Receive an accounting of disclosures of PHI.  You have the right to receive an accounting of the disclosures we have made of PHI about you after April 14, 2003 for most purposes other than treatment, payment, or health care operations.  The accounting will exclude certain disclosures, such as disclosures made directly to you, disclosures you authorize, disclosures to friends or family members involved in your care, and disclosures for notification purposes.  The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations.  To request an accounting, you must submit a request in writing to Reasor’s Pharmacy’ Privacy Officer.  Your request must specify the time period, but may not be longer than six years.  The first accounting you request within a 12 month period will be provided free of charge, but you may be charged for the cost of providing additional accountings.  We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.

Request communications of PHI by alternative means or at alternative locations.  For instance, you may request that we contact you about medical matters only in writing or at a different residence or post office box.  To request confidential communication of PHI about you, you must submit a request in writing to the Reasor’s Pharmacy where your PHI resides.  Your request must state how or where you would like to be contacted.  We will accommodate all reasonable requests.

Examples of How We May Use and Disclose PHI

The following are descriptions and examples of ways we use and disclose PHI:

We will use PHI for treatment.  Example:  Information obtained by the pharmacist will be used to dispense prescription medications to you.  We will document in your record information related to the medications dispensed to you and services provided to you.  

We will use PHI for payment.  Example:  We will contact your insurer or pharmacy benefit manager to determine whether it will pay for your prescription and the amount of your copayment.  We will bill you or a third-party payer for the cost of prescription medications dispensed to you.  The information on or accompanying the bill may include information that identifies you, as well as the prescriptions you are taking.

We will use PHI for health care operations.  Example:  The Pharmacy may use information in your health record to monitor the performance of the pharmacists providing treatment to you.  This information will be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.

We are likely to use or disclose PHI for the following purposes:

Business associates:  There are some services provided by us through contracts with business associates.  Examples include billing and delivery services.  When these services are contracted, we may disclose PHI about you to our business associate so that they can perform the job we have asked them to do.  If applicable, we may bill you or your third-party payer for services rendered.  To protect PHI about you, we require the business associate to appropriately safeguard the PHI.

Communication with individuals involved in your care or payment for your care:  Health professionals such as pharmacists, using their professional judgment, may disclose to a family member, other relative, close personal friend or any person you identify, PHI relevant to that person’s involvement in your care or payment related to your care.

Health-related communications:  We may contact you to provide refill reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Food and Drug Administration (FDA):  We may disclose to the FDA, or persons under the jurisdiction of the FDA, PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Worker’s compensation:  We may disclose PHI about you as authorized by and as necessary to comply with laws relating to worker’s compensation or similar programs established by law.

Public health:  As required by law, we may disclose PHI about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law enforcement:  We may disclose PHI about you for law enforcement purposes as required by law or in response to a valid subpoena or other legal process.

As required by law:  We must disclose PHI about you when required to do so by law.

Health oversight activities:  We may disclose PHI about you to an oversight agency for activities authorized by law.  These oversight activities include audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Judicial and administrative proceedings:  If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order.  We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the requested PHI.

We are permitted to use or disclose PHI about you for the following purposes:

Research: We may disclose PHI about you to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information.

Coroners, medical examiners, and funeral directors:  We may release PHI about you to a coroner or medical examiner.  This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to carry out their duties.

Organ or tissue procurement organizations:  Consistent with applicable law, we may disclose PHI about you to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Fundraising: We may contact you as part of a fundraising effort.

Notification:  We may use or disclose PHI about you to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and your general condition.

Correctional institution:  If you are or become an inmate of a correctional institution, we may disclose PHI to the institution or its agents when necessary for your health or the health and safety of others.

To avert a serious threat to health or safety:  We may use and disclose PHI about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

Military and veterans:  If you are a member of the armed forces, we may release PHI about you as required by military command authorities.  We may also release PHI about foreign military personnel to the appropriate military authority.

National security and intelligence activities:  We may release PHI about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective services for the President and others:  We may disclose PHI about you to authorized federal official so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Victims of abuse, neglect, or domestic violence:  We may disclose PHI about you to a government authority, such as a social service or protective services agency, 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 if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.

Other Uses and Disclosures of PHI

We will require your written authorization prior to: any use or disclosure of your psychotherapy notes (except in limited circumstances); any use or disclosure of your PHI for marketing purposes; or sale of your PHI.

The Pharmacy will request your written completion of our Authorization Form before using or disclosing PHI about you for purposes other than those provided for above (or as otherwise permitted or required by law).  You may revoke an authorization in writing by completing our Authorization Revocation Form at any time.  Upon receipt of the written revocation, we will stop using or disclosing PHI about you, except to the extent that we have already taken action in reliance on the authorization.

We will notify you in the event of a breach of unsecured Protected Health Information that affects you.

For More Information or to Report a Problem

If you have questions or would like additional information about the Pharmacy’s privacy practices, you may contact the Reasor’s Pharmacy Privacy Officer.   If you believe your privacy rights have been violated, you can file a complaint with the Reasor’s Pharmacy Privacy Officer or with the Secretary of Health and Human Services, 200 Independence Ave., SW, Washington DC  20201, phone number (202) 619-0257.  There will be no retaliation for filing a complaint.

 

Effective Date: 08/22/2013

Attn. Privacy Officer

420 South 145th E. Ave, Suite B. Tulsa, OK 74108

918-947-8180 Extension 3079

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    00201064000009

    SKU/UPC

    20106400000
  • Size

    1 ct

    Identifier

    00738761300151

    SKU/UPC

    73876130015
  • Size

    10.75 oz

    Description

    90 calories per 1/2 cup. Paris International Exposition: 1900. CampbellsKitchen.com. Recipes are a click away. Satisfaction guaranteed. If you have questions or comments, please call 1-800-257-8443. Please have code and date information from container. Visit Our Website at: www.campbellsoup.com. Steel - Please recycle where facilities available. For More Recipes, Visit: Campbell'sKitchen.com. Partially produced with genetic engineering. For information about GMO ingredients visit WhatsinMyFood.com. whatsinmyfood.com. Cooked with care in the USA.

    Identifier

    00051000000118

    SKU/UPC

    5100000011

    Manufacturer

    Campbell Soup

    Brand

    Campbells
  • Size

    405.6 oz

    Identifier

    00078767800010

    SKU/UPC

    7876780001
  • Size

    2 ltr

    Description

    Diet Coke is a delicious, crisp tasting, no calorie sparkling cola that gives you the refreshment you want throughout the day

    Identifier

    00049000050110

    SKU/UPC

    4900005011

    Manufacturer

    Coca Cola

    Brand

    Diet Coke
  • Size

    405.6 oz

    Description

    DASANI offers a wide variety of water products that range from purified water, sparkling water, water flavor drops, and flavored water.

    Identifier

    00049000031652

    SKU/UPC

    4900003165

    Manufacturer

    The Coca-Cola Company

    Brand

    Dasani
  • Size

    lb

    Description

    Package weight vary 3 to 5lb per package.

    Identifier

    00201704000000

    SKU/UPC

    20170400000
  • Size

    2 ltr

    Description

    150 calories per 12 fl oz serving. Est. 1885. Caffeine Content: 41mg/12 fl oz. Let's Play: letsplay.com. Drpepper.com. Please recycle.

    Identifier

    00078000082463

    SKU/UPC

    7800008246

    Manufacturer

    Dr Pepper/Seven Up

    Brand

    Dr Pepper
  • Size

    10.75 oz

    Description

    60 calories per 1/2 cup. Paris International Exposition: 1900. Inspected for wholesomeness by US Department of Agriculture. 100% recyclable. 100% delicious. Clip & earn 1 point for your school! Labels for Education. labelsforeducation.com. This Campbell's Chicken Noodle soup is made with 32 ft. of fresh egg noodles (14.75 and 50 oz. sizes use dry egg noodles) and other good, honest ingredients like lean chicken meat. It has no artificial flavors and is low in fat & cholesterol. Delicious goodness in every bite. Visit Our Web Site at: www.campbellsoup.com. Satisfaction guaranteed. If you have questions or comments, please call 1-800-257-8443. Please have code and date information from container. Visit Our Website at: www.campbellsoup.com. Steel - Please recycle where facilities available. Cooked with care in the USA.

    Identifier

    00051000012517

    SKU/UPC

    5100001251

    Manufacturer

    Campbell Soup

    Brand

    Campbells
  • Size

    lb

    Identifier

    00203238000006

    SKU/UPC

    20323800000
  • Size

    32 oz

    Description

    Per 1/4 Inch Slice: 70 calories; 2.5 g sat fat (13% DV); 400 mg sodium (17% DV); 2 g sugars. Melts better and 45% less fat than cheddar cheese! See nutrition information for saturated fat and sodium content. Velveeta contains 4 g fat per serving; cheddar cheese contains 9 g fat per serving. Visit us at: velveeta.com. 1-800-634-1984 please have package available. Facebook: Like us on Facebook!

    Identifier

    00021000066346

    SKU/UPC

    2100006634

    Manufacturer

    Kraft Foods

    Brand

    Velveeta
  • Size

    12 pack

    Description

    Enjoy Coca-Cola’s crisp, delicious taste with meals, on the go, or to share. Serve ice cold for maximum refreshment.

    Identifier

    00049000028904

    SKU/UPC

    4900002890

    Manufacturer

    The Coca-Cola Company

    Brand

    Coca-Cola
  • Size

    64 oz

    Description

    37% less fat than whole milk

    Identifier

    00072060007114

    SKU/UPC

    7206000711

    Manufacturer

    HILAND DAIRY

    Brand

    HILAND
  • Size

    lb

    Identifier

    00201657000003

    SKU/UPC

    20165700000
  • Size

    1 lb

    Description

    Fresh taste. Guaranteed! US inspected and passed by Department of Agriculture. Gluten free. Visit us at www.jimmydean.com. For questions or comments, call 1-800-925-Dean.

    Identifier

    00077900115530

    SKU/UPC

    7790011553

    Manufacturer

    Hillshire Brands

    Brand

    Jimmy Dean
  • Size

    15 oz

    Identifier

    00070038347903

    SKU/UPC

    7003834790
  • Size

    12 pack

    Description

    Est. 1885. Authentic blend of 23 flavors. 150 calories per can. Let's Play: Let's Play! We're donating $15 million to build or fix up 2,000 playgrounds. And 5 million kids will be jumping for joy. Join us at letsplay.com. Consumer comments? 1-888-Drpepper. See unit container for manufacturer's identity. Caffeine Content: 41 mg/12 fl oz. Please recycle. drpepper.com.

    Identifier

    00078000082166

    SKU/UPC

    7800008216

    Manufacturer

    Dr Pepper/Seven Up

    Brand

    Dr Pepper
  • Size

    16 oz

    Description

    Four quarters. Premium quality. USDA US Grade AA. Officially graded.

    Identifier

    00070038362586

    SKU/UPC

    7003836258

    Manufacturer

    Associated Wholesale Grocers

    Brand

    Best Choice
  • Size

    lb

    Identifier

    00000000040808

    SKU/UPC

    4080
  • Size

    lb

    Identifier

    00201696000002

    SKU/UPC

    20169600000
  • Size

    46 oz

    Description

    Pictures are examples of what cake may look like. Actual product may vary from picture. If there is a character you want but it is not listed please contact the store. If our Cake Designers have any questions they will reach out to you regarding the cake design. Leave writing info or any special instructions in the notes section at order checkout. Any special orders please call the Bakery Department at the store you choose.

    Identifier

    00207825000004

    SKU/UPC

    20782500000
  • Size

    11.5 oz

    Description

    Limited batch! Naturally and artificially flavored. Kellogg's Family Rewards. Let the good times roll! Homemade cinnamon rolls are one of our favorites. So we, Elves, worked our magic to bake all that freshly baked scrumptiousness into this special batch of uncommonly good cookies. One thing about special batches - they don't last long! - Ernie Keebler. Collect points. Earn rewards. Two easy ways to collect points! Go to KFR.com to learn more. how2recycle.info. Come see uncommonly good things at www.keebler.com. Follow us on - Facebook. Questions or comments? Visit: keebler.com. Call: 1-877-453-5837. Provide production code on package.

    Identifier

    00030100113720

    SKU/UPC

    3010011372

    Manufacturer

    Kelloggs

    Brand

    Keebler
  • Size

    9.25 oz

    Description

    Great for dipping. Gluten free. Guaranteed fresh until printed date or this snack's on us. Good fun! SmartLabel. Scan for more food information. Questions or comments? 1-800-352-4477, Mon-Fri 9:00am to 4:30pm CT/email or chat at fritolay.com. Facebook: Find us on: facebook.com/fritolay.

    Identifier

    00028400589321

    SKU/UPC

    2840058932

    Manufacturer

    Frito Lay

    Brand

    Fritos
  • Size

    gallon

    Description

    Since 1906. All natural. Fresh brewed. Red Diamond all natural tea is brewed by pouring hot, fresh water over our original 1906 blend of custom-fired, hand-crafted tea leaves. We are not made with powder, liquid concentrate, or tea flavorings. This is our expression of art. Proudly shared since 1906. www.reddiamond.com.

    Identifier

    00070242301258

    SKU/UPC

    7024230125

    Manufacturer

    Red Diamond

    Brand

    Red Diamond
  • Size

    1 dozen

    Description

    Vegetarian fed hens. Farm fresh. Americas Superior Tasting Egg. USDA A Grade. Now! For your nutritious diet. Excellent source of Vitamins D, E, B2, B12, B5. Plus - 140 mg Omega 3. 25% less saturated fat than regular eggs. Egglands best eggs just got even better! Farm fresh Egg-Land's Best eggs have always been recognized for their exceptional taste. In fact, we've been awarded the Gold Seal as America's Superior Tasting Eggs by the American Masters of Taste. Now, in addition to their great taste, they are an excellent source of vitamin D, vitamin E and vitamin B2 (riboflavin), vitamin B12 and vitamin B5 (pantothenic acid) and also a good source of folate. Plus, our eggs contain 125 mg of omega 3 fatty acids and 200 mcg of lutein and have 25% less saturated fat than regular eggs. How does Eggland's Best produce such nutritious and great-tasting eggs? We feed our hens an improved wholesome, all-vegetarian diet with no animal fats or animal by-products. Laying hens' diets contain no added hormones. Antibiotics are not used in the production of Eggland's Best eggs. The results: our all-vegetarian diet produces important nutrients and the best taste possible. So you can eat even healthier while enjoying the same great right-from-the-farm freshness and taste of Eggland's Best eggs! Recommended American Diabetes Association/American Dietetics Association Dietary Exchange: 1 Egg-land's Best egg for 1 medium-fat meat. BrandSpark. Most trusted by shoppers. Voted most trusted egg brand by American shoppers. Based on the 2017 BrandSpark Study. Saturated fat 25% less than ordinary eggs: 1 g vs. 1.5 g (quantities rounded). If you are concerned about cholesterol, follow a diet lower in saturated fat and cholesterol and ask your doctor or dietician about Eggland's Best clinical studies. For Kosher Questions: See www.oukosher.org. Visit www.egglandlandbest.com for additional information. Questions or comments call 800-922-3447 or visit www.egglandsbest.com.

    Identifier

    00715141729283

    SKU/UPC

    71514172928

    Manufacturer

    Egg-Lands Best

    Brand

    Egglands Best
  • Size

    9.75 oz

    Description

    Doritos® Tortilla Chips Nacho Cheese. Spicy nacho flavored. Net wt 9 3/4 oz (276.4g). Guaranteed fresh. Until printed date or the snack's on us. Questions or comments 1-800-352-4477. Mon-Fri 9:00am to 4:30pm CT. Email or chat at fritolay.com. ©2013 Frito-Lay North America, Inc.

    Identifier

    00028400642033

    SKU/UPC

    2840064203

    Manufacturer

    Frito-Lay, Inc.

    Brand

    Doritos
  • Size

    12 oz

    Description

    King's Hawaiian® Original Hawaiian Sweet Rolls. Established 1950. Pe 1 roll serving: 90 Calories. 1g Sat fat, 6%. 80mg Sodium, 3%DV. 5g Sugars. Net Wt 12 oz (340 g). Original Hawaiian recipe. Our story: Back in the 1950s in Hilo, Hawaii, a young man named Robert R. Taira had a passion for baking. Working with the finest ingredients, he refined his recipe until he created a bread that was soft, sweet and irresistible. Today, three generations of the Taira family continue the legacy and the aloha spirit, staying true to the original recipe. Our rolls are wonderful warm from the oven or straight from the bag. Make them into sliders or bite-sized sandwiches. A pack of 12 delicious rolls means some for you and some to share. Try out other irresistible products! Jalapeno, Savory Butter and Honey Wheat Rolls: Irresistible flavors sure to please any crowd! Hot Dog Buns and Hamburger Buns: Make any grilling occasion special! Recyclable package. King's Hawaiian® is a registered trademark of King's Hawaiian Holding Co., Inc. All rights reserved. If you have any questions or comments, Consumer care: (877) MY-KHCARES (877) 695-4227. Please email us at: khcares@kingshawaiion.com. For delicious recipe ideas, visit us online at: www.kingshawaiian.com. ©2016 King's Hawaiian Holding Co., Inc.

    Identifier

    00073435000044

    SKU/UPC

    7343500004

    Manufacturer

    King's Hawaiian Bakery West, Inc.

    Brand

    King's Hawaiian
  • Size

    2 ltr

    Description

    Introduced in 1961, Sprite is the world's leading lemon-lime flavored soft drink. It has a crisp, clean taste that really quenches your thirst.

    Identifier

    00049000050158

    SKU/UPC

    4900005015

    Manufacturer

    Coca Cola

    Brand

    Sprite