Your Information. Your Rights. Our Responsibilities.

Effective date: August 1, 2021

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. It is our legal requirement, as a medical cannabis dispensary, to craft and share this notice with you. Please review it carefully.

How We May Use and Disclose Your Personal Health Information

We may use and disclose your Personal Health Information (PHI) without your express authorization for the following purposes:

• Treatment, Payment, and Health Care Operations
• Opportunity to Agree or Object;
• Incident to an otherwise permitted use and disclosure;
• Public Interest and Benefit Activities; and
• Limited Data Set for the purposes of research, public health or health care operations

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your purchase history

• You can ask to see or get an electronic or paper copy of any health information we have about you, including a record of all purchases made at Dispensary33. Ask us how to do this.
• We will provide a copy or a summary of your health information (that is, your purchase history), usually within 30 days of your request. If you ask for these records in some format other than by email, we may charge a reasonable, cost-based fee.

Request confidential communications

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. Get a copy of this privacy notice and further information about our privacy policy
• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
• To learn more about privacy policy please contact compliance@dispensary33.com

Choose someone to act for you

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights through a State web portal designed for this purpose at the following URL: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
• We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

How do we typically use or share your health information?

We can use and share your health information to run our dispensary, improve your care, and contact you when necessary.

Example: We use health information about you to discuss among our staff the best products to help you.

Q: How often does this happen?

A: All the time. We’re constantly trying to share knowledge to get better at what we do.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. We never market or sell personal information. For more information, see https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

Help with public health and safety issues

We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Help with your treatment

We can use your health information and share it with other professionals who are treating you if they specifically request information from us.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities. However, our activities are illegal under federal law, so billing and payment from health insurance providers will only occur with a change in federal statute or when a certain mythic, exceedingly warm place freezes over.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information, see https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.