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Participant acknowledges and agrees that by using the services offered by Envision Medical Solutions, affiliates and partners, certain information related to the prescriptions obtained through the program will be collected. Some of this information may be associated with Participant and may constitute protected health information (PHI) under HIPAA. Participant acknowledges and agrees that this information will be used for the administration of the program and any affiliate programs. Any PHI collected by Envision Medical Solutions, affiliates and partners, shall be maintained as confidential, protected in accordance with HIPAA, and not be disclosed except as authorized by Participant. By requesting certain information to be provided to Participant, either through the website, e-mails, text messages, or any other mode of communication, Participant authorizes Envision Medical Solutions, affiliates and partners, to provide such information to Participant via such modes of communication. Participant hereby consents to the collection and use of the information by Envision Medical Solutions, affiliates and partners, in the manner described above. You acknowledge and agree that by using your card for discounted drugs, you consent to Envision sharing certain demographic and claims information with its affiliates and partners for purposes, which include but are not limited to, marketing and research. If you choose to opt out of affiliate and partner information sharing, you must contact Envision Medical Solutions in writing at: 3710 Corporex Park Drive, Suite 215, Tampa, FL 33619.
Prices subject to change without notice. Price only for quantities stated, additional quantities may incur higher costs. THIS IS NOT INSURANCE. Discounts are available only at participating pharmacies.
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