HIPAA Authorization & Disclosure

Pill Pals Express Pharmacy (Pill Pals) provides healthcare services to the general public. Patients may register for an account with Pill Pals either online or in person. By creating an account with Pill Pals Express Pharmacy, you authorize the use or disclosure of your protected health information as described below:

  • You authorize all of your prescribers, caregivers, and other personnel involved in your care to provide us with the totality of your health history
  • Information that may be disclosed may encompass the entirety of your health history (past, present, and future). All time periods of your heath information may be shared.
  • Pill Pals is authorized to acquire this information starting on the day you register, and ending on the day you terminate your membership with Pill Pals.
  • You understand that the information provided to Pill Pals may be subject to re-disclosure to either a healthcare provider or caregiver that is directly involved in your care; but only on a need to know basis. For example, Pill Pals employees may discuss your health history with a Physician (MD) for the purpose of dispensing your medications.
  • Pill Pals does not share your medical history with law enforcement unless served with a warrant, subpoena, court order, or other legally demanding document.
  • You have the right to revoke this authorization at any time by cancelling your membership via any of the following means:
    • In Writing: 1100 Historic 66 West, Waynesville, MO 65583
    • By Phone: 855.816.7257
  • You understand that any action taken in reliance on this authorization cannot be reversed, and that revoking your authorization will not affect those actions.
Pill Pals EXPRESS Pharmacy

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