Resources for Privacy Practices
We believe that privacy is part of Walgreens commitment to you. If you have a complaint about our privacy practices or would like to exercise any of your rights under HIPAA, please contact us using the appropriate form below, or contact us at customerservice@mail2.walgreens.com.
Complaint Form
If you have a complaint about our privacy practices, please use the online complaint form opens in a new window, print out a complaint form opens in a new window to mail to us, or contact the Privacy Office directly using the contact information below:
- 108 Wilmot Road, Mail Stop 3213
- Deerfield, Illinois 60015
- 877-924-4472
Patient Request Forms
Use the forms below to exercise one or more of your rights in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Forms should be returned to Walgreens using the contact information specified on each form.
Friends and Family Designation
Designate a family member, friend, caregiver, etc. to receive information about your health on an on-going basis to assist with your care and maintaining your information.
Designation Form opens in a new window
Request for Accounting of Disclosures
Request a list of certain disclosures of your health information.
Accounting Form opens in a new window
Request to Access, Inspect, or Obtain PHI
Request a copy of your health information be sent to you or to any recipient you specify. This form is commonly used to send records to individuals involved in your care, such as family members and providers.
Access Form opens in a new window
Request for Alternate Means of Communication
Request communications in a specific way or at a specific location for privacy reasons.
Alternate Communications Form opens in a new window
Request to Amend/Correct Protected Health Information
Request corrections or updates to your health information if you believe it is inaccurate or incomplete.
Amendment Form opens in a new window
Request Restrictions on Protected Health Information Use and Disclosure
Request limits on how we use or share your health information for treatment, payment, or healthcare operations.
Restrictions Form opens in a new window