Patient Rights & Responsibilities
YOUR RIGHTS:
CARE THAT IS:
> Considerate, respectful and compassionate regardless of your race, age, gender, religion, sexual orientation, or physical or mental disability.
> Safe: free from all forms of neglect, abuse, exploitation, or harassment.
PRIVACY:
< All communications with health care providers are kept confidential. Records are released only when the patient (or parent) gives permission, or when the law requires it.
> Immigration status is kept private within legal limits.
< A Notice of Privacy Practices
will be given to you to explain our policy on information privacy, use and disclosure, and the procedure to report someone violating this right.
CHOICE:
> You may refuse care, ask for a second opinion, or change your provider at any time.
YOUR RIGHTS:
INFORMATION:
> We will give you information on organ donation and Advanced Directives, if you ask.
> You will be given information about your health condition, including treatment and outcome expectations, and allowed to participate in all decisions about your care.
> You will be given information on the names, titles, and educational qualifications of everyone who provides your care, including students and volunteers.
> We will offer you educational information in a language or format that you can understand.
> You may review your medical records at any time with a staff member present. (You may need to make an appointment.) You may
arrange to get a copy of your own medical record.
> Billing information, including charges and payment schedules will be given to you if you ask.
> Information will be posted on how to file either anonymous or confidential complaints. If you need more information, you may ask any staff member.
YOUR RESPONSIBILITIES:
COMMUNICATION:
> Tell your health care provider about your health history and all the medicines you take. Be sure to include any vitamins, supplements, herbs, and "over-the-counter" medicines.
> Ask questions if you don't understand or need more information.
> Tell your provider if you can't follow your treatment plan.
> Give clinic staff all the information to bill your insurance properly.
RESPECT:
> Show respect for other patients' and staff members' person, property, and privacy. Abusive, threatening, or inappropriate language or behavior will not be tolerated.
> Respect the providers' and other patients' time by being on time for all appointments or canceling at least 24 hours in advance.
UNDERSTANDING:
> Understand that you are responsible for the consequences if you refuse treatment or do not follow through with the treatment plan you
agree to.
> Understand that medical treatments are only part of living a healthy life. Lifestyle choices can make your treatments not work, or not work as well.