At Worker’s Choice we know just how busy life can be, and to help you maintain your treatment and stay pain free, we offer an automatic refill program. Qualifying prescriptions will be sent to you automatically as soon as your medication is available for refill. When your last prescribed refill is coming up, we can work with your physician to help get it renewed.
Enrollment into the Peace of Mind Automatic Refill Program is free and easy! Simply complete the information below and return to Workers’ Choice to get started. If you have any questions about the program, please call the pharmacy at (855) 969-3443. We appreciate your business and wish you Peace of Mind!
Download Autofill Program Form
Effective May 1, 2013, the new federal law known as the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) requires that this pharmacy comply with certain rules and regarding the maintenance of the privacy of your information that we have collected and will collect in the future.
To comply with one of HIPAA’s requirements, we are offering you a copy of our Notice of Privacy Practices. This Notice of Privacy Practices contains the necessary information that HIPAA requires us to disclose regarding our privacy practices.
Download Patient Acknowledgement Form
The Pharmacy is required by law to maintain the privacy of the health information it maintains about its customers (also known as “Protected Health Information” or “PHI”) and to provide its customers with notice of our legal duties and privacy practices with respect to PHI. PHI is information that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This Notice of Privacy Practices (“Notice”) describes how we may use and disclose PHI to carry out treatment, obtain payment or perform our health care operations and for other specified purposes that are permitted or required by law. This Notice also describes your rights with respect to PHI about you.
Download Privacy Practices