Instructions

HIPAA/Patient Rights

  1. You have the right to be treated with respect, consideration and dignity.
  2. You have the right to high-quality medical care delivered in a safe, timely, efficient and cost-effective manner and the right to be assured that the expected results can be reasonably anticipated.
  3. You have the right to privacy to the extent possible.
  4. You have the right to have your disclosure and records treated confidentially and, except when required by law, those disclosures and records will not be released without your approval
  5. You have the right to be provided, to the degree known, complete information concerning your diagnosis, evaluation, treatment and prognosis.
  6. You have the right to copies of your medical records at a nominal cost and, if you request it, those records will be transferred to another practitioner in a timely manner.
  7. You have the right to be informed of all reasonable options or alternatives for care and/or treatment and of the potential advantages and disadvantages of each including the advantages or disadvantages and the alternative to having the procedure performed in an office or other outpatient facility.
  8. You have the right to participate in decisions regarding all aspects of care.
  9. No procedure or treatment will be undertaken without your informed consent after the alternatives mentioned in #7, above have been discussed with you.
  10. You have the right to refuse any diagnostic procedure or treatment and to be advised of the likely medical consequences of such refusal.
  11. You have the right to know all of your rights as outlined above.
  12. You have the right to know the conduct expected of you in the facility and the consequences of failure to comply with these expectations.
  13. You have the right to know the services available at the facility.
  14. You have the right to know the provisions for after-hours and emergency care.
  15. You have the right to know if any of the planned procedures or treatments is part of a research study and the right to refuse to participate in that study.
  16. You have the right to know whether or not your providers are insured.
  17. You have the right to know how to go about expressing suggestions to the facility and the policies regarding grievance procedures and external appeals in the event that you are dissatisfied with your treatment.
  18. You have the right to know the name of your provider.
  19. You have the right to know what fees are expected and what the payment policies are.
  20. You have the right to know what your provider's credentials are.
  21. You have the right to change providers.