Patient's Bill of Rights and Responsibilities
As a patient you have the right to:
As a patient you have the responsibility to:
I understand that at any time I may contact my physician or go to the hospital if I feel appropriate. I have been informed of and understand my Bill of Rights and Responsibilities.
- Be treated with dignity and respect.
- Be informed about the services/products to be rendered to you.
- Participate in the development and revision of your Plan of Care which will be individualized to meet your needs.
- Be given appropriate and professional quality without discrimination against your race, creed, color, religion, sex, national origin, sexual preference, handicap or age.
- Be given proper identification by name and title of everyone who provide services to you.
- Be given information concerning aspects of your condition as they relate to the care provided.
- Be given data privacy and confidentiality.
- Have access to and review your clinical record at your written request.
- Refuse treatment after being fully informed of the consequences of such actions.
- Be given information at the time of admission of the charges for services and policy concerning payment for services including insurance coverage and any other methods of payment.
As a patient you have the responsibility to:
- Give accurate and complete health information concerning your past medical history, medications, allergies, and other pertinent information.
- Maintain a safe environment ad use and maintain equipment/supplies as instructed.
- Inform the company when you will not be home for deliveries.
- Participate in the development and revision of your Plan of Care.
- Adhere to your Plan of Care.
- Contact the company if you are admitted to the hospital.
- Request further information concerning anything you do not understand.
I understand that at any time I may contact my physician or go to the hospital if I feel appropriate. I have been informed of and understand my Bill of Rights and Responsibilities.