Notice of Privacy Practices

Form P3-v3 · Effective August 3, 2026 · Collins Pharmacy, Inc. and its divisions as a single covered entity under HIPAA

We are required by law to protect the privacy of your health information, to give you this notice explaining our legal duties and privacy practices, and to follow the terms of the notice that is currently in effect. We take that responsibility seriously. Please read this notice, and ask us anything you are unsure about — we are happy to explain it.

1. How we may use and share your health information without your permission

There are three everyday reasons we use your health information. We do not need your written permission for these.

Treatment

To provide and coordinate the equipment, supplies and services you need. For example, we may speak with your doctor to confirm your prescription, or share your setup information with a therapist involved in your care.

Payment

To bill and collect payment from Medicare, Medicaid, your insurance plan, the Department of Veterans Affairs, a waiver program, or you. For example, we may send your insurer information about the equipment we delivered so your claim can be paid.

Health care operations

To run our business well and improve the care we give. For example, we review patient records for quality, train our staff, and prepare for accreditation surveys.

Other situations permitted by law

The law also allows us to use or share your information, without your permission, in these specific situations:

• When required by federal, state or local law.
• For public health activities — for example, reporting a problem with a medical device to the Food and Drug Administration, or reporting a product recall.
• To report suspected abuse, neglect or domestic violence to an agency authorized to receive it.
• For health oversight activities such as audits, inspections, licensure and accreditation reviews.
• In response to a court order, subpoena, warrant or other lawful process.
• To law enforcement, in the limited circumstances the law allows.
• To coroners, medical examiners and funeral directors so they can carry out their duties.
• For organ, eye or tissue donation purposes.
• For research that has been reviewed and approved through a formal process protecting your privacy.
• To prevent a serious and imminent threat to your health or safety, or to that of others.
• For specialized government functions, including military, veterans and national security activities.
• For workers' compensation claims, as authorized by law.
• With business associates — contractors who perform services on our behalf, such as billing, delivery, IT support or record shredding. Each one is required by written contract to protect your information.

People involved in your care

Unless you tell us not to, we may share information relevant to your care with a family member, caregiver or other person you have involved in your care or who helps pay for it. If you are not able to tell us your preference — for example, in an emergency — we will use our best judgment about what is in your interest. Please tell us at any time if you want to limit this.

Appointment, delivery and service reminders

We may contact you by phone, text message, letter or email to remind you about a scheduled delivery, arrange a service call, confirm a resupply shipment, or tell you about a treatment alternative or a health-related benefit that may interest you. Tell us if you prefer we do not, or if you want us to use a particular method or number.

2. Uses that always require your written permission

We will not use or share your health information for any of the following without your written authorization:

• Most uses and sharing of psychotherapy notes, if we ever hold any.
• Marketing communications, where we would receive payment from a third party for making them.
• Any sale of your health information.
• Any other purpose not described in this notice.

If you give us written permission, you may take it back at any time by telling us in writing. Withdrawing permission stops any future use or sharing, but it cannot undo something we have already done in reliance on it.

3. Your rights

You have the following rights regarding the health information we hold about you. To exercise any of them, contact our Privacy Officer using the details in section 7. We will not treat you differently, refuse you service, or retaliate in any way because you exercised a right or filed a complaint.

Get a copy of your record

You may inspect and receive a copy of the health information we use to make decisions about your care. If we keep it electronically, you may ask for an electronic copy. We will respond within 30 days. We may charge a reasonable, cost-based fee for copying and postage, and we will tell you the cost before we proceed.

Ask us to correct your record

If you believe information we hold is wrong or incomplete, you may ask us to amend it. We will respond within 60 days. If we decline, we will explain why in writing and you may submit a statement of disagreement to be kept with your record.

Get a list of disclosures

You may request an accounting of certain disclosures we have made in the previous six years. Disclosures for treatment, payment and health care operations, and those you authorized, are not included. The first request in any twelve-month period is free.

Ask us to limit what we share

You may ask us to restrict how we use or share your information. We are not required to agree, with one exception: if you pay for an item or service in full out of your own pocket, and you ask us not to share that information with your health plan, we must agree unless a law requires us to share it.

Choose how we contact you

You may ask us to contact you at a particular address or phone number, or by a particular method. We will accommodate reasonable requests and will not ask you to explain why.

Get a paper copy of this notice

You may ask for a paper copy at any time, free of charge, even if you agreed to receive it electronically. Just call us and we will mail one or hand it to you.

Be told if your information is breached

We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

Choose someone to act for you

If you have given someone medical power of attorney, or if someone is your legal guardian, that person may exercise these rights on your behalf. We will confirm their authority before acting.

4. Our legal duties

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

5. Changes to this notice

We may change this notice at any time, and the changes may apply to information we already hold as well as information we receive in the future. The current version will always be posted on this page, displayed in our office, and available on request. The effective date appears at the top of this page.

6. Complaints

If you believe your privacy rights have been violated, please tell us. We want to know, and we will look into it. You may complain by telephone or in writing — you do not have to put it in writing, and you do not have to complain to us first.

7. Contact us

If you have any question about this notice, want a paper copy, or want to exercise any right described in section 3:

Privacy Officer

Chris Collins

Telephone

(203) 576-8642, extension 3021

Email

chris@collinsmedical.net

Mail

Collins Medical Equipment, 1526 Barnum Avenue, Suite 1, Bridgeport, CT 06610