• I am between the ages of 18 and 64.
• All of the answers I provide are true, correct & complete to the best of my knowledge.
• I acknowledge that online healthcare management is an emerging element of total personal health care, and that, as such, I am assuming more responsibility for my health care choices and decision-making than I might otherwise have been asked to assume within the traditional health care setting.
• I have reasonably & diligently explored the various options regarding my health and wellness goals, including information available on this website and others, as well as other sources of credible health information, and I am well informed.
• I am requesting this medication solely for my therapeutic and medical needs, and will not distribute to other people, even if their complaints, symptoms or health goals are exactly like mine.
• I am participating in this program at my own choice, at my own expense, and my own liability, and I assume full responsibility for my participation.
• I am legally entitled to use the credit card I have offered for payment of professional services and products.

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This notice describes the privacy practices of our site. This company and its staff have agreed to the terms of this Notice of Privacy Practices.

This privacy notice and the privacy practices explained in this notice notify you of our commitment to protecting private health information, and permitting patients to exercise their rights concerning health information. No legal relationship between these medical staff and companies is created or implied for any other purpose.

Your health care information is your personal information. We know that information about your medical history and your health care is private. To process orders, we must create certain records which contain information about your health. These records include questionnaires, profiles, and billing records.

The law requires that we give you written notice of our privacy practices, and requires that we follow the terms of our privacy notice currently in effect. This Notice of Privacy Practices describes our commitment and the commitment of our employees and contractors to the protection and confidentiality of your health information. This notice also describes your rights concerning your health information, including your right to inspect and amend your health information. We are committed to following the law which requires that protected health information is kept private subject to legal requirements which authorize or require its disclosure in limited circumstances.

How We May Use and Disclose Health Information

Unless we have your written authorization, we will not use and disclose your protected health information, except under the limited circumstances explained below. We will not disclose protected health information about you for any other reason without your written authorization. If you give us an authorization permitting us to release protected health information, you may revoke the authorization in writing, except to the extent we have already disclosed information pursuant to the authorization.

A. Health Information is Used to Allow Us to Fill Your Orders. We may use or disclose your protected health information for the purpose of providing treatment to you through the filling of orders and allowing our staff to evaluate whether our products are appropriate for you. For example, if you request a product, a licensed physician will evaluate whether you meet the criteria to receive that product based upon your health information provided to the physician. The request for that product, along with information you have provided concerning your health, will be provided to a licensed pharmacy for the purpose of filling the order.

B. Limited Information is Used to Obtain Payment for Product Orders. We obtain payment for our services through your credit card company or through a check processing service. The only information we share with your credit card company or check processing service is your name, billing address and phone number, and credit card number. For customers paying by check, we also provide your checking account number to a check processing service. We do not share any information with your credit card company or check processing service which discloses the type of product dispensed to our customers. All personal and credit card information is submitted using Secure Encryption Technology.

C. Information May Be Used for Health Care Operations. We may use or disclose health care information for our operations. For example, we may use information concerning your order to evaluate the quality of care and services our staff is providing to you. Our site and affiliated websites, the physicians, and pharmacies involved with your care may also disclose health care information to each other as necessary to assist them with providing treatment to you, operating their companies, or to obtain payment.

D. Reorder Reminders and Information about Treatment Alternatives. We may use health care information to contact you by e-mail for the purpose of reminding you of your ability to obtain reorders, or inform you about treatment alternatives or other health related benefits and services that may be of interest to you. Please advice our Privacy Officer by e-mail or U.S. mail at the privacy contact address described at the end of this Notice if you do not wish us to contact you concerning reorder reminders, treatment alternatives, or other health related benefits and services that may be of interest to you.

E. Disclosures as Required by Law. We may use or disclose protected health information if required to do so by federal, state, or local law. The use or disclosure will be made in compliance with the law, and will be limited to the relevant requirements of the law. For example, we may be required to disclose your health information in relation to cases of suspected abuse, neglect, domestic violence or certain physical injuries, or to respond to a subpoena, or order of a court or administrative tribunal.

F. Disclosures for Public Health Activities. We may be required to disclose protected health information for public health activities to a public health authority authorized by law to collect or receive this information, such as the Food and Drug Administration, for the purpose of preventing or controlling disease, injury, or disability.

G. Disclosures to Coroners and Medical Examiners. We may be required to disclose health information about patients who have died to coroners and medical examiners so they may carry out their duties, such as determining the cause of death.

H. Disclosures Concerning Organ Donors. If you are an organ donor, we may be asked to disclose information concerning your health or products we have dispensed to organ procurement organizations, eye banks, and other similar organizations for the purpose of facilitating organ, eye or tissue donation and transplantation.

I. Disclosures to Avert a Serious Threat to Health. As required by law and standards of ethical conduct, we are permitted to release your health information to the proper authorities if we believe, in good faith, that such release is necessary to prevent or minimize a serious and imminent threat to your, the public's, or another individual's health or safety.

J. Disclosures for Health Oversight Activities. We are permitted to disclose your health information to a health oversight agency for monitoring and oversight activities authorized by law. This might include release of information to the state agency that licenses pharmacies for the purpose of monitoring or inspecting pharmacies related to that license.

K. Disclosures for Workers Compensation Purposes. We may be required to release protected health information about you to the extent necessary to follow the laws relating to workers compensation or other similar programs that provide benefits for work related injuries or illness.

L. Disclosures to Business Associates. We may request certain businesses to assist us with our health care operations. In the event it is necessary to disclose protected health information pertaining to our customers to these business associates, we will enter into written contracts with them requiring that they keep protected health information private and secure.

Your Rights Pertaining to Your Health Care Information

A. Right to Request Confidential Communications. We intend to communicate with our customers primarily by e-mail at the e-mail address which you provided to us and to ship orders to the shipping address you have provided. You have the right to request that we communicate with you in a certain way or at a certain location. For example, you can ask that we only contact you by U.S. mail at a private post office box. We will not ask you the reason for your request.

To request we communicate with you to a specific location, or in a particular manner, please obtain our "Request for Communications via Specific Means or at Alternative Locations" form by contacting our Privacy Officer as described later in this Notice, and submit the completed form to our Privacy Officer by e-mail or U.S. mail. We will accommodate all reasonable requests.

B. Right to Request Restrictions. You have the right to ask for restrictions on how your health information is used or to whom your information is disclosed, even if the restriction affects your treatment, our payment, or health care operation activities. However, we are not required to agree to your requested restriction and, even if we agree to the requested restriction, we are permitted to use your information without complying with the restriction if necessary to treat you in an emergency situation.

To request a restriction, please obtain our "Request for Restrictions on the Use and Disclosure of Health Information" form by contacting our Privacy Officer as described later in this Notice, and submit the completed form to our Privacy Officer by e-mail or U.S. mail.

C. Your Right to Inspect and Obtain a Copy of Your Health Information. You have the right to inspect and obtain a copy of health information that we maintain about you. This includes order records and billing records. To inspect or request a copy of your health information, please contact and obtain our "Request to Copy or Inspect Records" form from our Privacy Officer as described later in this Notice, and submit the completed form to our Privacy Officer specifying the records you would like to inspect or to have us copy for you. If you request a copy of the records, we may charge a fee for the cost of copying, mailing, or services associated with your request. In certain very limited circumstances, the law provides that we may deny your request to inspect or copy these records. If you are denied access to health information, you may request that the denial be reviewed by a licensed health care professional chosen by us who did not participate in the original decision to deny your access to review your request and the reasons for the denial.

D. Your Right to Request an Amendment to Your Health Information. If you believe the health information within your medical record is incorrect, you may ask us to amend the information. Please submit such requests in writing by e-mail or U.S. mail to our Privacy Officer at the address listed below, and include the requested amendment along with a reason you believe your health information should be amended. We are not required, however, to honor your request if we did not create the information you are requesting be amended or if the information in your record is correct. We will respond to your request in writing within 60 days of the date of receipt of your written request for amendment of your information, unless we advise you we require an additional 30 days.

E. Right to an Accounting of Disclosures. You have the right to request a list accounting for any disclosures of your protected health information we have made, except for uses and disclosures for a) treatment, payment, and health care operations, b) disclosures to you, c) disclosures pursuant to your authorization, and d) disclosures for certain other limited reasons specified by law. To request a list of disclosures, please contact our Privacy Officer by e-mail or U.S. mail at the address listed below, and obtain our "Request for an Accounting of Disclosures of Protected Health Information" form, and submit the completed form to the Privacy Officer. Your request must state a time period which may not be longer than six years, and may not include dates before April 14, 2003. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will mail you a list of disclosures within 60 days of your request, unless we advise you we require a period of up to an additional 30 days to comply with your request.

F. Right to a Paper Copy of this Notice. You have the right to obtain a paper copy of this notice at any time. To obtain a paper copy, please request it from our Privacy Officer at the address listed below. You may also view and print a copy of our Notice of Privacy Practices at our site.
G. Effective Date. This revised Notice of Privacy Practices is effective on January 1, 2004, and pertains to all protected health information we maintain.

H. Changes to this Notice. We reserve the right to change this notice, and we may make the revised or changed notice effective for all protected health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice on our website. The notice will contain an effective date. In addition, each time you request products from us, our current Notice of Privacy Practices will be available to you. Our current Notice of Privacy Practices may be viewed on our website or this website, and may be obtained by requesting it by telephone, by e-mail, or in writing from our Privacy Officer.

I. Complaints. We are committed to safeguarding your protected health information. Despite our good faith efforts, questions, concerns, mistakes, and misunderstandings may arise. If you have a concern or believe that we may have violated your privacy rights, we encourage you to bring that to our attention.

You may bring any complaints or concerns regarding your privacy rights to our attention by calling 1-800-571-8037 and requesting to speak with our Privacy Officer or their authorized representative. If you prefer, you may submit a complaint in writing to our Privacy Officer. You also may complain to the Secretary of the Department of Health and Human Services or his or her authorized representative if you believe your privacy rights have been violated.

We take all concerns and complaints very seriously and will investigate each one promptly. If we made a mistake, we will do what we can to correct it and take steps to prevent mistakes in the future. Under no circumstances will we retaliate against you for expressing a concern or filing a complaint relating to your privacy rights.

J. Privacy Officer and Privacy Contact Person. If you have any questions about this notice or wish to exercise any of your privacy rights, please contact our site Privacy Officer, or their authorized representative.

K. Acknowledgment of Receipt of this Notice. We will request you electronically acknowledge you have received a copy of this notice when you first request we provide services to you by checking a box acknowledging your receipt of this Notice of Privacy Practices. Please check this box only if you have received this Notice.