HIPAA Policy

Schraft’s, LLC

Notice of Privacy Practices

Last Updated: March 1, 2019

THIS NOTICE DESCRIBES HOW MEDICAL AND PHARMACEUTICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Notice of Privacy Practices addresses the legal duties and privacy practices of Schraft’s 2.0,

LLC (“Schraft’s,” “we,” “us,” or “our”) regarding the protected health information (“PHI”) of

individuals that use our services as an online pharmacy focused on fertility drugs (“patients,”

“you,” or “your”), and their rights under the Health Insurance Portability and Accountability Act,

as amended (“HIPAA”).

I. Uses and Disclosures of PHI. PHI is information about a patient, including demographic

information, that may identify the patient and is related to the patient’s past, present or future

physical or mental health or condition and related health care services. There are circumstances

where we are not required to a receive patient’s written authorization to use or disclose patient

PHI, outlined in Section (A) below, and Section (B) provides circumstances when patient written

authorization is required to use or disclose the patient’s PHI.

A. Patients’ Prior Written Authorization Not Required.

1) Business Associates. There are some services provided by us through contracts with HIPAA

business associates. When these services are contracted for, we may disclose our patients’ PHI to

our business associates so that they can perform the job we have asked them to do and bill the

applicable patient or your third-party payor for services rendered. To protect our patients’ PHI,

we require the business associate to appropriately safeguard the PHI and sign a business

associate agreement with us.

2) Treatment. We are permitted to use and disclose our patients’ PHI in connection with their

medical treatment in situations such as allowing a family member, other relative, close personal

friend or other person involved in the patient’s health care to pick up the patient’s prescriptions

and to receive PHI that is directly related to the patient’s care. In doing so, we are to use our

professional judgment and experience with common practice in determining what is in the

patient’s best interest. Other examples include sending information about a patient’s

prescriptions to the patient’s family doctor or to a specialist who is treating the patient or to a

hospital where the patient is receiving care, particularly if the patient has suffered a health

emergency.

3) Payment. If a patient is covered by a pharmacy benefit plan, we are entitled to send PHI to

the plan or to another business entity involved in our billing system describing the medication or

health care equipment we have dispensed so that we can receive payment.

4) Health Care Operations. In addition, we can provide PHI for health care operations such as

evaluations of the quality of our patients’ health care in order to improve the success of treatment

programs. Other examples include reviews of health care professionals, insurance premium

rating, legal and auditing functions, and business planning and management.

Additional Disclosures of Our Patient’s PHI Without Written Authorization are Permitted

under the Following Circumstances:

a) When requires by law to do so, such as reporting patients’ health information to state, federal,

or local law enforcement officials, court officials, or government agencies, such as the FDA.

b) When ordered by authorized public health officials for the purpose of carrying out public

health activities, such as to report product problems, or exposure to a communicable disease.

c) When the use/disclosure relates to victims of abuse, neglect or domestic violence.

d) When the use/disclosure is for health oversight activities, such as by written request of a

state/federal government agency performing management audits, financial audits, and program

monitoring.

e) When the use/disclosure is for judicial and administrative proceedings, such as in response to

an order of a court.

f) When the use/disclosure is to provide notification and reporting of an unsecured breach as

required by law.

g) When the use/disclosure is for law enforcement purposes, such as reporting certain types of

wounds or injuries, or if there is a good faith belief the disclosure is necessary to prevent or

lessen a serious, imminent threat to the safety of a person or the public.

h) When the use/disclosure is related to death, such as disclosing a patient’s health information to

coroners, medical examiner and funeral directors so they can carry out their duties related to such

patient’s death.

i) When the use/disclosure is related to cadaveric organ, eye, or tissue donation purposes.

j) We may disclose information about our patients for military activities, national security and

intelligence activities, and for protective services to the President of the United States.

k) We may disclose information about our patients to a correctional institution having lawful

custody of such patients.

l) We may disclose your health information as authorized by and to the extent necessary to

comply with the laws related to workers’ compensation or other similar programs established by

law.

m) When the use/disclosure relates to certain research purposes. For example, in limited

circumstances, we may disclose your information to researchers preparing a research protocol or

if an institutional review board determines authorization is not necessary.

B. Patients’ Prior Written Authorization Required.

For purposes other than those mentioned above, we are required to ask for our patients’ written

authorizations before using or disclosing any of their PHI. If we request an authorization, any of

our patients may decline to agree, and if a patient gives us an authorization, the patient has the

right to revoke the authorization at any time and by doing so, stop any future uses and

disclosures of the patient’s health information that the authorization covered. An example of a

situation where the patient’s prior authorization would be required would be if we wish to

conduct a marketing program that would involve the use of PHI, or disclosures that constitute

sale of PHI, explained in further detail below.

Marketing. We must obtain our patients’ written authorization prior to using patients’ PHI for

purposes that are marketing under the HIPAA privacy rules. For example, we will not accept any

payments from other organizations or individuals in exchange for making communications to our

patients about treatments, therapies, health care providers, settings of care, case management,

care coordination, products, or services unless the patient has given us his or her authorization to

do so or the communication is permitted by law. We may communicate with patients about a

product that is currently prescribed so long as any payment we receive in relation to making the

communication is reasonably related to the cost of making the communication. In addition, we

may market to patients in a face-to-face encounter and give patients promotional gifts of nominal

value without obtaining patients’ written authorization

Sale of Protected Health Information. We will not make any disclosure of PHI that is a sale of

Protected Health Information without our patients’ written authorization.

II. Patients’ Rights. HIPAA (and associated regulations) provide our patients with rights

concerning their PHI. With limited exceptions (which are subject to review) each patient has the

right to the following:

1) Patient’s Record. Each patient has the right to access and copy the patient’s PHI contained in

a designated record set upon written request. The designated record set usually will include

prescription and billing records. We may charge patients a fee as authorized by law to fulfill such

requests. Upon receiving a patient’s request to access his or her PHI, we are required to respond

to the patient no later than thirty (30) days after the receipt of the request. We may deny the

request to inspect and copy in certain limited circumstances. If a patient is denied access to his or

her PHI, the patient may request that the denial be reviewed. Patients may request access to their

health information in a certain electronic form and format, if readily producible, or, if not readily

producible, in a mutually agreeable electronic form and format. Further, patients may request in

writing that we transmit such a copy to any person or entity they designate. The written, signed

patient request must clearly identify such designated person or entity and where we should send

the copy. To inspect or copy PHI, patients should email us at info@schrafts2.com.

2) Accounting for Disclosures. Each patient can, upon written request, obtain a list of the

disclosures of the patient’s PHI by us that have occurred within the 6 years preceding the

request, except for disclosures made for the purposes of treatment, payment or health care

operations and certain others. We will provide patients with an accounting no later than sixty

(60) days after receipt of such request, with an option to extend for an additional thirty (30) days

if we are unable to provide the accounting within the time required. There will be no charge for

the first request in any twelve (12) month period, but we are entitled to charge a reasonable cost

based fee for additional requests made in the same period of time. Patients should submit

requests for an accounting of disclosures to info@schrafts2.com.

3) Amendments. Each patient may ask to change the record of his or her own PHI upon written

request explaining why the change should be made. We will review the request, but may decline

to make the change if in our professional judgment we conclude that the record should not be

changed. If we deny your request for amendment, you have the right to file a statement of

disagreement with the decision and we give a rebuttal to your statement. We will respond to

patient requests no later than sixty (60) days after receipt of such request, with an option to

extend for an additional thirty (30) days if we are unable to provide the accounting within the

time required. Patients should submit requests for an amendment to info@schrafts2.com.

4) Confidential Communications. Upon written request, each patient can ask us to

communicate with him or her about their own PHI in a confidential manner such as by sending

mail to an address other than the home address or using a particular telephone number. Patient

requests must state how or where the patient would like to be contacted. We will attempt to

accommodate all reasonable requests, and will not request an explanation for the basis for the

request. Patients should submit requests for confidential communication to info@schrafts2.com.

5) Special Restrictions. Upon written request, each patient can ask us to adopt special

restrictions that further limit our use and disclosure of the patient’s PHI (except where use and

disclosure are required of us by law or in emergency circumstances). You may also request that

any part of your PHI not be disclosed to family members or friends who may be involved in your

care or for your notification purposes. We will consider the request, but in accordance with

HIPAA we are not required to agree to with the request. Patients also have to right to request

restriction with regards to disclosure of health information to a patient’s health insurance

company if: (1) the disclosure is for the purpose of carrying out payment or health care

operations and is not otherwise required by law; and (2) the health information pertains solely to

a health care item or service for which we have been paid in full (other than by your health

insurance company). We will accommodate such a request, except where we are required by law

to make a disclosure. If we agree to your requested restriction, we will comply with your request

unless the information is needed to provide you emergency treatment. Patients should submit

requests for restriction to info@schrafts2.com.

6) Revoking Authorization. If a patient has signed an authorization to disclose information, the

patient can later revoke that authorization, in writing, to stop future uses and disclosures.

Revocation will not apply to disclosures or uses already made or taken in reliance on the

authorization. Patients should submit revocations to info@schrafts2.com.

7) Complaints. If a patient believes that we have violated the patient’s rights as to the patient’s

PHI under HIPAA or if a patient disagrees with a decision we made about access to the patient’s

PHI, the patient has the right to file a written complaint with our Contact Person listed below.

Our Contact Person is required to investigate, and if possible, to resolve each such complaint,

and to advise the patient accordingly. The patient also has the right to send a written complaint to

the U.S. Department of Health and Human Services at the address listed below. Under no

circumstances will we permit any retaliation against any patient for filing a complaint.

U.S. Department of Health and Human Services Office for Civil Rights

200 Independence Avenue, S.W.

Washington, D.C. 20201

+1.877.696.6775

www.hhs.gov/ocr/privacy/hipaa/complaints/

We are required by law to protect the privacy of our patients’ PHI, to provide this notice about

our privacy practices, and follow the privacy practices that are described in this notice. We

reserve the right to make changes in our privacy practices that will apply to all PHI that we

maintain. If or when we change our notice, we will post the new notice on our website.

Contact Information:

Corporate Compliance Officer

3 Wing Drive, Suite 102

Cedar Knolls NJ 07927

info@schrafts2.com

+1 855.724.7238

HIPAA Notice of Privacy Practices Acknowledgment Form

I acknowledge that I have received the HIPAA Notice of Privacy Practices (the “Notice”) from

Shcraft’s 2.0, LLC (“Schraft’s 2.0”). I have been provided an opportunity to review the Notice and

consent to its terms. I understand that:

• I have certain rights to privacy regarding my protected health information.

• Schraft’s 2.0 can and will use my health information for purposes of my treatment, payment for

treatment, and health care operations.

• The Notice explains in more detail how Schraft’s 2.0 may use and share my protected health

information for other purposes.

• I have the rights regarding my protected health information listed in the Notice.

• Schraft’s 2.0 has the right to change the Notice from time to time and I can obtain a current copy of

the Notice by contacting the person listed in the Notice.

Name:

Date: December 30, 2024

Date of Birth:

Relationship to Patient :

FOR OFFICE USE ONLY:

Good Faith Effort to Obtain Acknowledgment Form

Name of Patient:

Date of Birth:

I attempted to obtain the patient’s (or the representative of the patient) signature on the HIPAA Notice of

Privacy Practices Acknowledgment Form, but was unable to do so, as documented below:

Reason: _________________________________________________________________

Name: ___________________________

Date: ___________________________

Signature: _______________________________________________________________

HIPAA Authorization to Use and Disclose Protected Health Information

I. My Authorization

1. I hereby authorize Schraft’s 2.0, LLC (“Schraft’s 2.0) to use and/or disclose the protected health

information about me described below (“PHI”) to:

2. The PHI that may be used and/or disclosed is:

All of my health information

My health information relating to the following treatment or condition:

My health information covering the period of healthcare from December 30, 2024 to

Medications taken by patient:

3. The PHI may be used and/or disclosed for the following purpose(s):

Patient Services and Patient-related Treatment

4. Schraft’s 2.0 may disclose this health information to the following recipient(s):

My health information may be disclosed to the recipients identified above by the following methods:

Email and Regular Mail

5. This authorization shall remain in effect until:

6. Schraft’s 2.0 will not receive direct or indirect remuneration in exchange for disclosing the health

information to the above recipients.

II. My Rights

1. I understand that my treatment, payment, enrollment, or eligibility for benefits will not be conditioned

on whether I sign this form.

2. I understand that this medical information may be used by the person(s) I authorize to receive this

information for my medical treatment or consultation, billing or claims payment, or other purposes as I may

direct.

3. I understand that, as set forth in the notice of privacy practices, I have the right to revoke this

authorization, in writing, at any time, except to the extent that Schraft’s 2.0 has acted in reliance upon it on

my authorization, or if my authorization was obtained as a condition of obtaining insurance coverage and

the insurer has a legal right to contest a claim.

4. I understand that I have the right to refuse to sign this authorization.

5. I understand that PHI used or disclosed pursuant to this authorization may be redisclosed by the recipient

and its confidentiality may no longer be protected by federal or state law.

Name:

Date: December 30, 2024

Relationship to the Individual:

Welcome to Schraft’s 2.0!

We are grateful for the opportunity to assist you with all of your pharmacy needs.

Our mission at Schraft’s 2.0 is to be a specialty pharmacy offering superior patient care and specialty medications in a cost-effective manner with the ultimate objective to secure the best possible outcome for patients.

The staff at Schraft’s 2.0 understands that your medical and medication needs are unique and require special knowledge to effectively collaborate with your medical provider and insurance company. We are dedicated to providing you the personal service necessary to ensure that you achieve the maximum benefit. Schraft’s 2.0 offers all patients:

Our “Patient Management Program” including managing side effects, helping you understand your medications and what they are used for, and overall supports you through the process every step of the way.
Training, education and counseling.
Refill reminders, when necessary.
Delivery of your medication in a timely manner.
Access to clinically-trained personnel 24 hours a day, 7 days a week (including holidays and weekends).
Coordination of prior authorization with your insurance company.

Schraft’s 2.0 is located at:

3 Wing Dr, Suite 102

Cedar Knolls, NJ 07927

Our business hours are:

Monday-Friday: 8am to 8pm Eastern*

Saturday: 8am to 3pm Eastern*

Sunday: Closed

Phone: 855-SCHRAFT (855-724-7238)

After Hours Phone: 862-217-3598

Fax: 844-876-4545

Email: info@schrafts2.com

*Closed on all major holidays, including New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day

We look forward to providing you with the best service possible. We know you have many options and we thank you for choosing Schraft’s 2.0.

Sincerely,

The Schraft’s 2.0 Team

What to expect:

We recognize that your medical needs are unique and complex and possibly overwhelming. We are an independently owned pharmacy and are here for you. At Schraft’s 2.0, our staff is dedicated to working with you, your doctor(s) and nurse(s), as well as your family to achieve a fully integrated health care team. Our primary goal is to provide you quality care.

You can expect:

Personalized patient care

Our trained staff members will work with you to discuss your treatment plan and we will address any questions or concerns you may have.

Collaboration with your doctor

We work directly with your medical team to ensure any difficulties you may have with your treatment are addressed efficiently.

Regular follow-up

Getting your medications and medical supplies quickly and efficiently is important. We will be in close contact with you during your treatment and will be your healthcare advocate.

Benefits

Treatment can be costly. We will help you navigate through the complexities of the healthcare system to explore every option available to you. Our relationships with insurers will help provide you with information and explanations of your prescription and medical insurance benefits.

Delivery

We offer fast and convenient delivery to your home, workplace, or the location you prefer throughout all of the Unites States of America. A staff member will contact you the same day we receive your order to coordinate the medications you need, update your medical and insurance records, and to set up and confirm a delivery date and address.

24/7 Support

Our Pharmacy staff is available 24 hours a day, 7 days a week. We are always here to answer any questions or address any concerns you may have.

Double-Check

Upon receipt of your package, please open it immediately and double-check that your order is complete. If you have any questions, please contact us within 24 hours of receipt of your package at (855) 724-7238. We are unable to address any issues regarding the contents of your package if it is brought to our attention more than 24 hours after receipt.

Returns

In accordance with both Federal and State regulations, Schraft’s 2.0 cannot accept returns on medications once they have been dispensed. If an order is canceled prior to you receiving your package credit will be issued less a restocking fee. If you have any questions, please call us at (855) 724-7238.

When to contact us at (855) 724-7238:

If you have any questions or concerns about your medication.
To check the status of your prescription order.
To ask any question about your medications.
When you suspect a reaction or allergy to your medication.
A change has occurred in your medication use.
Your contact information or delivery address has changed.
Your insurance information or payment source has changed.
You need to check the status of your delivery.
You need to reschedule or change your delivery.
You have any questions or concerns about our specialty pharmacy service.

Payment Policy

Before your care begins, a staff member will inform you of your financial obligations that are not covered by your insurance or other third-party sources. These obligations include but are not limited to: out-of-pocket costs such as deductibles, co-pays, co-insurance, annual out of pocket limits, and life time out of pocket limits. We will also provide this information if there is a change in your insurance plan.

Insurance Claims

Schraft’s 2.0 will submit claims to your pharmacy insurance carrier on the date your prescription is filled. If the claim is rejected, a staff member will notify you, as necessary, so that we can work together to resolve the issue.

Co-payments

You may be required to pay a part of your medication cost, called a copayment. If you have a co-payment, it must be paid at the time of shipping or pick-up. We accept Visa®, MasterCard®, American Express®, and Discover®. We can maintain your credit card information on file in a secure environment.

Financial Assistance

We have access to financial assistance programs for some medications to help with high co-payments or out-of-pocket costs. These programs include discount coupons, programs from drug manufacturers, and assistance from various disease management foundations. We will assist you in enrollment into such programs.

How to Place an Order

To place a new order, after your doctor has submitted your prescription, please call us at (855) 724-7238 with the following information: Which medications ordered by your doctor you would like to receive, your insurance information, a shipping address for us to deliver to, and payment information. Please contact us as early as possible so we can ensure you will receive your medications on time.

PATIENT BILL OF RIGHTS AND RESPONSIBILITIES

Schraft’s 2.0 recognizes that patients have inherent rights. Patients who feel their rights have not been respected, or who have questions or concerns, should talk to the pharmacist on duty.

Patients and their families also have responsibilities while under the care of Schraft’s 2.0 in order to facilitate the provision of safe, high-quality health care for themselves and others. The following patient rights and responsibilities shall be provided to, and expected from, patients or legally authorized individuals.

To ensure the finest care possible, as a patient receiving our pharmacy services, you should understand your role, rights and responsibilities involved in your own plan of care.

As our patient, you have the right:

To select those who provide you with pharmacy services.
To receive the appropriate or prescribed services in a professional manner without discrimination relative to your age, sex, race, religion, ethnic origin, sexual preference or physical or mental handicap.
To be treated with friendliness, courtesy and respect by every individual representing our pharmacy, and be free from neglect or abuse, be it physical or mental.
To assist in the development and preparation of your plan of care that is designed to satisfy, as best as possible, your current needs, including management of pain.
To be provided with adequate information from which you can give your informed consent for commencement of services, the continuation of services, the transfer of services to another health care provider, or the termination of services.
To express concerns, grievances, or recommend modifications to your pharmacy services, without fear of discrimination or reprisal.
To request and receive complete and up-to-date information relative to your condition, treatment, alternative treatments, risk of treatment or care plans.
To receive treatment and services within the scope of your plan of care, promptly and professionally, while being fully informed as to our pharmacy’s policies, procedures and charges.
To request and receive data regarding treatment, services, or costs thereof confidentially.
To be given information as it relates to the use and disclosure of your plan of care.
To have your plan of care remain private and confidential, except as required and permitted by law.
To receive instructions on managing a drug recall.
To confidentiality and privacy of all information contained in the client/patient record including Protected Health Information (PHI); PHI will only be shared with the Patient Management Program in accordance with state and federal law.
To receive information on how to access support from consumer advocate groups.
To receive pharmacy health and safety information including consumer’s rights and responsibilities.
To know about the philosophy and characteristics of the Patient Management Program.
To have Personal Health Information (PHI) shared with the Patient Management Program only in accordance with state and federal law.
To identify the program’s staff members, including their job titles, and to speak with a supervisor of the staff member if requested.
To speak to a health professional at any time 24/7/365.
To receive information about the Patient Management Program.
To receive administrative information regarding changes in or termination of the Patient Management Program.
To decline participation, revoke consent or dis-enroll from the Patient Management Program at any point in time.
Be fully informed in advance about care/service to be provided, including the disciplines that furnish care and the frequency of visits, as well as any modifications to the plan of care.
Be informed, both orally and in writing, in advance of care being provided, of the charges, including payment for care/service expected from third parties and any charges for which the client/patient will be responsible.
Receive information about the scope of services that the organization will provide and specific limitations on those services.
Participate in the development and periodic revision of the plan of care.
Refuse care or treatment after the consequences of refusing care or treatment are fully presented.
Be informed of client/patient rights under state law to formulate an Advanced Directive, if applicable.
Have one's property and person treated with respect, consideration, and recognition of client/patient dignity and individuality.
Be able to identify visiting personnel members through proper identification.
Be free from mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of an unknown source, and misappropriation of client/patient property.
Voice grievances/complaints regarding treatment or care, lack of respect of property or recommend changes in policy, personnel, or care/service without restraint, interference, coercion, discrimination, or reprisal.
Have grievances/complaints regarding treatment or care that is (or fails to be) furnished, or lack of respect of property investigated.
To contact the New Jersey Board of Pharmacy if you have a concern that should be addressed by the organization at (973) 504-6450.
Be advised on agency's policies and procedures regarding the disclosure of clinical records.
Choose a health care provider, including choosing an attending physician, if applicable.
Receive appropriate care without discrimination in accordance with physician orders, if applicable.
Be informed of any financial benefits when referred to an organization.
Be fully informed of one's responsibilities.

Patients have the responsibility:

To provide accurate and complete contact information, your past and present medical history, other pertinent information, and to update the pharmacy should any changes occur.
To agree to a schedule of services and report any cancellation of scheduled appointments and/or treatments.
To participate in the development and updating of a plan of care.
To communicate whether you clearly comprehend the course of treatment and plan of care.
To comply with the plan of care and clinical instructions.
To accept responsibility for your actions, if refusing treatment or not complying with, the prescribed treatment and services.
To respect the rights of pharmacy personnel.
To notify your physician and the pharmacy with any potential side effects and/or complications.
To notify Schraft’s 2.0 via telephone when medication supply is running low so a refill maybe shipped to you promptly.
To submit any forms that are necessary to participate in the program to the extent required by law.
Voice grievances/complaints regarding treatment or care, lack of respect of property or recommend changes in policy, personnel, or care/service without restraint, interference, coercion, discrimination, or reprisal.
Voice grievances/complaints regarding treatment or care that is (or fails to be) furnished, or lack of respect of property investigated.

Specialty Pharmacy Patients have additional rights and responsibilities:

To know about philosophy and characteristics of the patient management program.
To have personal health information shared with the patient management program only in accordance with state and federal law.
The right to identify the program’s staff members, their job title, and to speak with a supervisor of a staff member’s supervisor if requested.
The right to speak to a health professional.
To receive information about the patient management program.
To receive administrative information regarding changes in or termination of the patient management program.
To decline participation, revoke consent or dis-enroll at any point in time.
To submit any forms that are necessary to participate in the program to the extent required by law.
To give accurate clinical and contact information and to notify the patient management program of changes in this information.
To notify their treating provider of their participation in the patient management program, if applicable.
To maintain any equipment provided.

Important Information

Patient Management Program
- As a patient of our specialty pharmacy program, we monitor your medications and progress through a disease/condition specific patient management program. This program is designed to provide benefits such as managing side effects, understanding your medications and overall helping you through the process every step of the way with the plan designed by you, your doctor, your nurse, and pharmacist. This service is provided to you at no cost, and your participation is voluntary. If you no longer wish to participate in our Patient Management Program, you may contact our team by phone to opt-out.

Refills
- If you would like to contact us for a refill, you can call us at (855) 724-7238 and speak to a patient care coordinator, nurse, or pharmacist to process your refill requests. Please know which medications you need the refill for, and have your payment and shipping information too. If your insurance information has changed, please notify us when you call. If we become aware that you require a refill before you, we will contact you the same day to set up your order and shipment.

Prescription Transfers
- If you feel that our pharmacy is unable to meet your needs, we can transfer your prescription to the appropriate pharmacy of your choice. Please call us at (855) 724-7238.

- If our pharmacy can no longer service your medication (insurance reasons, or the medication is out of stock), a pharmacist will transfer your prescription to another pharmacy. We will inform you of this transfer of care.

Delivery and Storage of your Medication
- We deliver medication to your home or an alternative location. We will also include appropriate supplies as need or as requested. We coordinate all refills to make sure that you, or an adult family member, is available to receive the shipment.

- If your medication requires refrigeration, we will ship it in special packaging that will maintain the appropriate temperature throughout the shipping process. Once you receive the package, please take the medication out of the box and place it in the refrigerator.

- If the package looks damaged or is not in the correct temperature range, please call us as soon as possible.

Adverse Drug Reactions
- If you are experiencing adverse effects to the medication, please contact your doctor or our pharmacy at (855) 724-7238 as soon as possible.

Drug Substitution Protocols
- From time to time it is necessary to substitute generic drugs for brand name drugs. This could occur due to your insurance company preferring the generic be dispensed or to reduce your copay. If a substitution needs to be made, a team member will contact you prior to shipping the medication to inform you of the substitution.

Proper Disposal of Sharps
- Place all needles, syringes, and other sharp objects into a sharps container. This will be included in your order if you are prescribed an injectable medication at a small fee. You can then call us to receive information on your local disposal sites, or to request a return label to ship it back to us.

Proper Disposal of Unused Medications:
- For instructions on how to properly dispose of unused medications, check with your local waste collection service. You can also check the following websites for additional information:

http://www.fda.gov/forconsumers/consumerupdates/ucm101653.htm

http://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

Drug Recalls
- If your medication is recalled, the pharmacy will contact you with further instructions, as directed by the FDA or drug manufacturer. If you have any questions about a medication recall, please contact us right away at (855) 724-7238.

Emergency and Disaster Preparedness Plan
- Schraft’s 2.0 has a comprehensive emergency preparedness plan in case of an emergency or disaster. Our primary goal is to continue to service your needs. Schraft’s 2.0 will utilize every resource available to maintain service level.
- We will contact you prior to any pending inclement weather and arrange delivery to you from our pharmacy or from another pharmacy we partner with, if we cannot deliver from our facility.
- In case of an emergency where we cannot arrange for delivery ahead of time, we will work with you to find the closest place for you to obtain your medications.
- In the event of a disaster or an emergency in your area, please contact us. This will ensure your therapy is not interrupted.
- In the event our facility is closed in an emergency, our phone system will roll over to our emergency line and you will still be able to reach a member of our team, including a pharmacist or a nurse.

Concerns or Suspected Errors
- We want you to be completely satisfied with the care we provide. If you have any issues with your medication, the services rendered, or any other issues related to your order, please contact us directly at (855) 724-7238 and speak to one of our staff members, or fax (844) 876-4545 or email us (info@schrafts2.com). We will address your concern within 1 business day.

You may also voice your concerns to any of our accrediting bodies:
- URAC
  - Email Address: grievances@urac.org
  - Phone: (202) 216-9010
- CPPA
  - info@pharmacypracticeaccredit.org
  - Phone: (202)-558-2712
- ACHC
  - Website: http://achc.org/contact/complaint-policy-process
  - Phone: (855) 937-2242 or (919)-785-1214

Cleaning your hands
- It is important that you clean your hands prior to starting your injection preparations and injecting.

- Cleaning with soap and water:
  - Wet your hands and wrists with warm water.
  - Use soap. Work up a good lather, and rub hard for 15 seconds or longer.
  - Rinse and dry your hands well.
  - Use a clean paper towel to turn off the water. Throw the paper towel away.

- Cleaning with hand sanitizer:
  - For gel product use one application.
  - For foam product use a golf-ball size amount.
  - Apply product to the palm of your hand.
  - Rub your hands together. Cover all surfaces of your hands and fingers until they are dry.

Home Safety Information
- If children are in the home, store medications out of their reach.
- When taking or giving medication, read the directions on the labels carefully.
- Do not share your medications with other people.
- Do not reuse syringes or needles.
- Discard all sharps in a sharps container.

For additional information regarding your condition or diagnosis, you can visit the following websites OR DOWNLOAD APPLICATIONS ON YOUR SMART PHONE:

www.asrm.org

www.resolve.org

www.ferringfertility.com

https://fertilitylifelines.com

www.merckconnect.com

www.fertilitybydesign.com

FertiCalm ™

Please sign and return this form at your earliest convenience via fax or email:

Fax: 844-876-4545

Email: info@schrafts2.com

I confirm that I have received Schraft’s 2.0 Welcome packet, which includes Hours of Operation, Contact Information, Patient Bill of Rights and Responsibilities, Financial Obligation, Complaint Process, and Return Policy.

Name:

Address: ,

Date: December 30, 2024

Thank you for choosing Schraft’s 2.0 to service all your specialty pharmacy needs.

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