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Dear Valued Patient,

Re: Important Information About the HIPAA Privacy Regulations

The United States Department of Health and Human Services has issued regulations establishing strict standards in how Pharmacies, like DrugSource, Inc., may use and disclose your medical records. These regulations are effective as of April 14, 2003.

Enclosed is a notice that explains the Rules in detail. In general, the regulations require DrugSource, Inc. to secure all medical information so that it is not readily accessible or available to those who do not need access to it. We will be able to discuss your information with you directly, but we will require your authorization to discuss this information with third parties, such as your spouse. In order to obtain this authorization, we must have a written authorization on file for you and your spouse, if married. (There is an exception in the Rules allowing parents to obtain information from us concerning their minor children.) We have enclosed an Authorization Form, additional forms can be obtained by photocopying, and encourage you to take a moment to review, complete, and return as many forms as needed to:
DrugSource, Inc.
P.O. Box 1366
Elk Grove Villlage, IL 60009-1366
Attn: Pharmacy Privacy Officer
Once authorized by you, we are permitted to disclose necessary information about you to the person(s) that you have designated on the Authorization Form(s).

Our commitment to protecting your privacy is not new. We will continue to safeguard your privacy and the confidentiality of the information provided to us related to your pharmaceutical needs.

View our Pharmacy Practices Statement Below

Downloadable Forms (right click to download or left click to print from this website)

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