Forms


CMS Medicare Durable Medical equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Supplier Standards

In order to satisfy the requirements of Medicare to bill diabetic testing supplies, each Medicare Part B patient must have access to the CMS DMEPOS Supplier Standards. Goodson Drug Company will provide a copy of this during the initial Part B setup and additional copies will be made available to the patient upon request. For convenience a copy is also made available online. Click Here.


Patient Bill of Rights and Responsibilities

In order to satisfy the requirements of Medicare to bill diabetic testing supplies, each Medicare Part B patient must have access to the Patient Bill of Rights and Responsibilities. Goodson Drug Company will provide a copy of this during the initial Part B setup and additional copies will be made available to the patient upon request. For convenience a copy is also made available online.  Click Here.


HIPAA Policy

Goodson Drug Company takes patient protected health information privacy very seriously. We will gladly provide a copy of our HIPAA policy upon request.   For convenience a downloadable copy is made available online.  Click Here.


HIPAA Privacy Release

In an effort to maintain patient protected health information (PHI) Goodson Drug Company requires that a patient fill out and sign a privacy release before any PHI will be sent. This release may be picked up at the pharmacy or downloaded online. Signed copies may be delivered in person or faxed to (770) 887-1699.  Click Here.



Application for Employment

Employment applications for Goodson Drug Company may be picked up at the pharmacy or filled out and downloaded online. Although signed applications can be dropped off anytime during normal business hours, applicants are encouraged to call first, (770) 887-5040, to ensure that the correct personnel will be present to receive the forms.  Click Here.


Medication Spending Reports


Please fill out the form below to submit a request for your Medication Spending Report. Name, phone number, Report start and end dates are required.

Your Name:*
E-mail:
Phone:*
-
Birthdate:*
Start Date:*
End Date:*