HIPAA Compliance Notice

Entity: International Rx in partnership with AscendPBM

Scope of Services

International Rx and AscendPBM provide patient qualification and intake services to help connect prospective patients with appropriate healthcare providers and pharmacies. We do not provide medical treatment, diagnosis, or prescriptions. Our role is limited to:

• Collecting initial patient information for qualification purposes
• Forwarding qualified patient information to licensed healthcare providers and pharmacies
• Facilitating communication between patients and healthcare partners

Limited Role in Healthcare

Important: By submitting information through our intake forms, you acknowledge that:

• We are not your healthcare provider
• We do not make medical decisions or provide medical advice
• We do not prescribe, dispense, or administer medications
• All medical decisions are made by licensed healthcare providers independent of our services
• Prescription fulfillment is handled by licensed pharmacies, not by International Rx

Information We Collect

For patient qualification purposes, we collect:

• Contact information (name, address, phone, email)
• Basic health information necessary to determine program eligibility
• Insurance information (if applicable)

This information is collected solely to assess whether you may qualify for GLP-1 treatment programs offered by our healthcare partners.

How We Handle Your Information

Information submitted through our intake forms is:

• Used only for patient qualification and referral purposes
• Shared with licensed healthcare providers and pharmacies who may provide treatment
• Stored securely with appropriate safeguards
• Not sold to third parties for marketing purposes

Third-Party Service Providers

We use the following service providers to process intake information:

• Hyland OnBase: Document management and workflow processing for patient intake forms
• Cloudflare: Website security and content delivery

Once you are qualified and referred to a healthcare provider or pharmacy, that provider becomes responsible for HIPAA compliance related to your treatment and medical records.

Your Rights

You have the right to:

• Request access to the information we have collected about you
• Request correction of inaccurate information
• Withdraw your intake submission before referral to a healthcare provider

For requests related to medical records or treatment information, please contact your healthcare provider or pharmacy directly.

Disclaimer of Liability

International Rx and AscendPBM:

• Make no guarantees regarding qualification for any treatment program
• Are not responsible for medical decisions made by healthcare providers
• Are not responsible for prescription fulfillment by pharmacies
• Are not liable for treatment outcomes or adverse events
• Do not establish a provider-patient relationship through our intake process

Contact Us

For questions about our intake process or the information we collect:

• Phone: (833) 200-5040
• Email: helpdesk@ascendpbm.com

For questions about your medical treatment or prescriptions, please contact your healthcare provider or pharmacy directly.