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Patient Bill of Rights

As a Patient, I have the RIGHT to:

  1. Full information about my rights and responsibilities as a patient in an Ambulatory Center;
  2. Receive an explanation of my diagnosis, benefits of treatment, alternatives, recuperation, risks and an explanation of consequences if treatment is not pursued;
  3. An explanation of all rules, regulations and services provided by the Center, the days and hours of service and provisions for possible emergency care, including telephone numbers;
  4. Choose the type of Medical Plan which is best suited to my particular situation and work with the physician members within my healthcare plan;
  5. Participate in development of a plan of care including Advance Directives and have my own copies;
  6. Refuse participation in any protocol or aspect of care including investigational studies, and freely withdraw my previously given consent for further treatment;
  7. Disclosure of any teaching programs, research or experimental programs in which the facility is participating;
  8. Full financial explanation and payment schedules prior to beginning treatment;
  9. Receive professional care without discrimination, regardless of race, creed, color, religion, national origin, sexual preference, handicap, sex or age;
  10. Be treated with courtesy, dignity and respect of my personal privacy by all employees of the Center;
  11. Be free of physical/mental abuse and/or neglect by all employees of the Ambulatory Center;
  12. Complain or file grievance with the Center Patient Representative without fear of retaliation or discrimination;
  13. Confidential treatment of my condition, medical record and financial information;
  14. Access to my personal records and obtain copies upon written request; and,
  15. Assistance and consideration in the management of pain.

As a Patient, I have the RESPONSIBILITY to:

  1. Disclose accurate and complete information related to physical condition, hospitalizations, medications, allergies, medical history and related items;
  2. Participate in developing a Plan of Care, Advance Directives and Living Will;
  3. Assist in maintaining a safe, peaceful and efficient ambulatory environment;
  4. Provide new/changed information related to my health insurance to the business office and be prepared to meet my agreed co-pay during my office visit.
  5. Contact the Center when unable to keep a scheduled appointment;
  6. Cooperate in the planned care and treatment developed for me;
  7. Request more detailed explanations for any aspect of service I don’t understand;
  8. Inform my physicians and nurses of any changes in my condition or any new problems or concerns;
  9. Communicate any temporary or permanent change in my address or telephone number which might hinder contact by the Ambulatory Center staff;
  10. Relate my levels of discomfort and/or pain and perceived changes in my pain management to my physician.
  11. Inform my physician or nurse when I am going to need a prescription refill before my supply is gone.