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Patient Rights and Responsibilities



  1. Obtain relevant, accurate, current and understandable information from your Mercy Pharmacy Pharmacist  concerning your treatment and/or drug therapy

  2. Discuss your specific drug therapy, the possible adverse side effects and drug interactions, and to receive effective counseling and education from your Mercy Pharmacy Pharmacist

  3. Expect that all prescribed medications you receive are accurately dosed, effective and in useable condition

  4. Choose the pharmacist and pharmacy provider where your prescriptions are filled and to not be pressured or coerced into transferring your prescriptions to another pharmacy or mail order service

  5. Confidentiality and privacy of all your patient counseling information contained in your patient record and all your Protected Health Information, as described in Mercy Pharmacy’s Notice of Privacy Practices (NOPP).

  6. Receive appropriate care without discrimination in accordance with physician orders

  7. Be advised if a medication has been recalled at the consumer level

  8. Call Mercy Pharmacy with any complaints about medication or privacy matters at 877-200.5254 and ask for the Chief Compliance Officer, or contact us about them through our website,

  9. Voice your grievances/complaints regarding treatment or care or lack of respect or to recommend changes in policy, personnel, or care/service without restraint, interference, coercion, discrimination, or reprisal, and have your grievances/complaints investigated.

  10. Be able to identify Mercy Pharmacy representatives through proper identification.

  11. Choose a healthcare provider.

  12. Receive information about the scope of care/services that are provided by Mercy Pharmacy directly or through contractual arrangements, as well as any limitations to Mercy Pharmacy’s care/service capabilities.

  13. Receive in advance of care/services being provided, complete oral and written explanations of charges for care, treatment, services and equipment, including the extent to which payment may be expected from Medicare, Medicaid, or any other third party payer, charges for which you may be responsible, and an explanation of all forms you are requested to sign.

  14. Be informed of any financial benefits that might accrue when you are referred to an organization.

  15. Be advised of any change in Mercy Pharmacy’s plan of service before the change is made.

  16. Receive information in a manner, format and/or language that you understand.


17.  Have family members, as appropriate and as allowed by law, and with your authorization or the authorization of your personal representation, be involved in your care and treatment, and/or service decisions affecting you.

18.  Be fully informed of your responsibilities.

19.  To obtain services regardless of race, nationality, sex, age, sexual orientation, physical and/or mental disabilities, diagnosis or religious affiliation.

20.  To speak to a health professional.

21.  To have personal health information shared with the patient management program only in accordance with state and federal law

22.  To receive information about the patient management program

23.  To receive administrative information regarding changes to or termination of the patient management program.

24.  To decline participation, revoke consent, or disenroll at any time.






  1. Adhere to the plan of treatment or service established by your physician.

  2. Participate in the development of an effective plan of care/treatment/services.

  3. Provide, to the best of your knowledge, accurate and complete medical and personal information necessary to plan and provide care/services.

  4. Ask questions about your care, treatment and/or services, or to have clarified any instructions provided by Mercy Pharmacy representatives.

  5. Communicate any information, concerns and/or questions related to perceived risks in your services, and unexpected changes in your condition.

  6. Notify Mercy Pharmacy if you are going to be unavailable for scheduled delivery times.

  7. Treat Mercy Pharmacy personnel with respect and dignity without discrimination as to color, religion, sex, or national or ethnic origin.

  8. Care for and safely use medications, supplies and/or equipment, per instructions provided, for the purpose they were prescribed and only for/on the individual for whom they were prescribed.

  9. Mercy Pharmacy should be notified of any changes in your physical condition, physician’s prescription or insurance coverage. Notify Mercy Pharmacy immediately of any address or telephone changes whether temporary or permanent.

  10. Understand that Mercy Pharmacy acts solely as an agent for you in filling for insurance or other benefits assigned to Mercy Pharmacy; Understand that Mercy Pharmacy assumes no responsibility for assuring that benefits so assigned will be paid; and understand that your account will only be credited when Mercy Pharmacy receives payment.

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