Your Rights as a Nutrition Patient
Access to Care
- Receive nutrition services without discrimination based on race, color, religion, gender, national origin, age, disability, or ability to pay
- Request a different nutrition provider if desired
- Receive timely responses to questions and concerns
Quality of Care
- Receive professional, evidence-based nutritional care
- Have your cultural, psychosocial, spiritual, and personal values respected
- Participate actively in developing your nutrition care plan
- Receive clear explanations about your nutritional status and recommended interventions
Privacy and Confidentiality
- Have your medical and personal information kept confidential
- Review your nutrition records upon request
- Expect privacy during consultations
Your Responsibilities as a Patient
Providing Information
- Supply accurate, complete information about your medical history
- Report any dietary restrictions, allergies, or supplements
- Inform us about any cultural or religious dietary requirements
Participation in Treatment
- Follow the agreed-upon nutrition care plan
- Attend scheduled appointments
- Provide 24-hour notice for appointment cancellations
- Ask questions when you don't understand something
Financial Obligations
- Provide accurate insurance information
- Pay agreed-upon fees in a timely manner
- Discuss any financial concerns with our billing department
Acknowledgment
I have read and understand my rights and responsibilities as a nutrition patient.
Patient Name: _____________________
Signature: ________________________
Date: ____________________________