b'Your Responsibilities as a Patient 9.Call our office if you have any questions aboutBIOPLUS SPECIALTY PHARMACY PATIENT GUIDEBOOKthe companys information or about yourAs a patient, you have the responsibility to: consent forms.1. Give accurate and complete health information 10. Sign and return your consent forms if required concerning your past illnesses, hospitalizations, by your insurance plan. medications, allergies, insurance coverage, andother issues pertinent to your therapy. 11.Take care of and maintain any equipment that isprovided to you by the company.2.To carry out your therapy as instructed, tomaintain a safe home setting for the storage and 12.Notify the pharmacy of any changes to yourproper use of your medications, and to be contact information. available or return calls to pharmacy staff todiscuss response and tolerance of therapy once 13.Request more information about anything youyou have been introduced to our pharmacy and do not understand, including billing questions.Patient Management Program.14.Notify the pharmacy if you are admitted to a3.Notify the pharmacys nurse or pharmacist of hospital, if the doctor stops your therapy, or ifside effects or significant changes in your you plan to travel while receiving therapy.medical condition.15.Submit any forms that are necessary to4.Participate in planning your care. participate in the program, to the extentrequired by law.5. Respond to our outreach to schedule your next refill. 16.Notify your treating provider of participationin the Patient Management Program, if6.Communicate if you do not comprehend the applicable.course of treatment or care plan.17.Pay certain charges should they not be covered7.Respect the rights of pharmacy personnel. by your insurance and/or arrange specialpayment plans as needed.8.Review the information about our companysent to you in your first shipment. 18.Voice complaints or concerns about treatmentissues to the pharmacy staff or to a pharmacist.If you are in the state of CT and you have a concern that an error may have occurred in the dispensing of your prescription you may contact the Department of Consumer Protection, Drug Control Division, by calling 1-860-713-6065.If you are in the state of FL call Home Health Hotline 1-888-419-3456, if you need to resolve any complaints or need questions answered regarding a Home Health Agency. Hours of operation: 8:00 a.m to 5:00 p.m. Monday through Friday except holidays. If you are in the state of FL and need to report abuse, neglect, or exploitation: 24 Hour Hotline 1-80096ABUSE (1-800-962-2873). If you are in the state of TX and need to report abuse, neglect, or exploitation: Abuse Hotline: 800-252-5400.If you are in the state of SC call for Home Health complaints:803-545-4370or http://www.scdhec.gov/Health/FindingQualityHealthcare/FileaComplaint/FileaComplaint-AllOtherHealthcareFacilities/ If you are in the state of Maine, mail complaint to Complaint Coordinator, Office of Professional and Occupational Regulation, 35 State House Station, Augusta, ME 04333-0035. If you are in the state of CA and Medi-Cal patient for a complaint call: 916-552-9500 or email: email@example.comAccreditation Commission for Health Care: 1-919-785-1214.The products and/or services provided to you by the pharmacy are subject to the supplier standards contained in the Federal regulations shown at 42 Code of Federal Regulations424.57(c). These standards concern business professional and operational matters. The full text of these standards can be obtained at http://www.ecfr.gov. Upon request we will furnish you a written copy of these standards. The products and/or services provided to you by the pharmacy are subject to Florida Patients Bill of Rights and Responsibilities shown at Florida Statutes381.026. The full text of this statute can be obtained at http://www.leg.state.fl.us/statutes/. Upon request we will furnish you a written copy of these rights and responsibilities. RESPONSIBILITIESRev 01/202416 The BioPlus Family of Pharmacies'