We have a variety of forms and other information that can be helpful for our Pharmacy patients.
This packet includes information we provide to our new patients and was sent to all our current patients when it was created as well.
It includes Patient Rights and Responsibilities, HIPAA Notice of Privacy Practices, Grievance/Complaint Reporting, information on the safe handling of medication, storage, drug disposal and sharps disposal guidelines, as well as other information. The bulk of the packet can be viewed or downloaded here:
Individual Forms (found in the Welcome Packet):
HIPAA Privacy Practices
Patient Authorization and Plan of Service
PHI Release Form
Pharmacy Patient Bill of Rights
Customer Satisfaction Survey (Example)
If you have any questions or problems gaining access to these forms, please contact us at 303-724-0168 or toll free at 888-724-7427, or contact us via email at firstname.lastname@example.org.
We encourage our pharmacy patients to be proactive with their health and be involved in the bleeding disorder community for support and education. Some wonderful options for patients:
National Hemophilia Foundation- Colorado Chapter
Rocky Mountain Hemophilia & Bleeding Disorders Association
National Hemophilia Foundation
Hemophilia Federation of America
World Federation of Hemophilia
World Health Organization
Centers for Disease Control and Prevention