Acknowledgement of Rights and Responsibilities and Notice of Privacy Practices

To Our Valued Patients:

As an MUSC Specialty Pharmacy Patient, we want to make sure you have received and understand MUSC Health's Patient Rights and Responsibilities as well as Notice of Privacy Practices.

You can find the Patient's Rights and Responsibilities and the Notice of Privacy Practices in the specialty pharmacy welcome packet, on our website or below in the attached documents.

Please review and sign that you have received a copy below. If you have any questions, please contact MUSC Specialty Pharmacy at 843-876-7074.

Attachment:

MUSC Health Patient Rights and Responsibilities (English).pdf

Attachment:

MUSC Health Patient Rights and Responsibilities (Spanish).pdf

Attachment:

MUSC Health Notice of Privacy Practices (English).pdf

Attachment:

MUSC Health Notice of Privacy Practices (Spanish).pdf

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I understand by checking this box this constitutes a legal signature and confirms that I have received and understand my Rights and Responsibilities as well as the Notice of Privacy Practices provided by MUSC Specialty Pharmacy.

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