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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION YOU SUBMITTED THROUGH THE ONLINE PRESCRIPTION REFILL
FEATURE OF THIS WEB SITE MAY BE USED AND DISCLOSED. ALSO PLEASE REVIEW THE CLINTON MEMORIAL HOSPITAL
WEB SITE SECURITY POLICY AND THE CLINTON MEMORIAL HOSPITAL
NOTICE OF PRIVACY PRACTICES FOR MORE INFORMATION.
- All information submitted in the online prescription refill form is a confidential part of your
medical record. If you choose to provide your E-Mail address you will be added to a guest book and may receive
future electronic mailings from Clinton Memorial Hospital.
- The information you submit on the online prescription refill form is made available to Clinton
Memorial Pharmacy personnel for the purpose of refilling your existing prescription. By submitting this form,
you are authorizing Clinton Memorial Pharmacy to contact your insurance company for verification of coverage and
payment.
PLEASE NOTE:
If your prescription label does not list Clinton Memorial Pharmacy, please call Clinton Memorial Pharmacy
directly to change the location for your prescription refill. Prescriptions cannot be transferred online.
Please allow 4 hours for refill requests to be processed, 24 hours if your refill is a compound. Orders placed
between 8 a.m. and 1 p.m. will be processed on the same day. Clinton Memorial Pharmacy will only have access to
your order during business hours.
Revised March 13, 2003
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