Your Rights as a Patient
Access to Care
- Receive quality chiropractic care regardless of race, gender, religion, or disability
- Be treated with respect and dignity
- Receive care in a clean and safe environment
- Request a second opinion or change practitioners
Information and Communication
- Receive complete information about your diagnosis, treatment, and prognosis
- Access your medical records as permitted by law
- Have your health information kept confidential
- Receive clear explanations of all procedures and treatments
Treatment Decisions
- Participate in decisions about your care
- Refuse treatment after understanding the consequences
- Be informed about alternative treatment options
- Know the names and qualifications of your healthcare providers
Your Responsibilities as a Patient
Information Sharing
- Provide accurate and complete medical history
- Inform us about current medications and supplements
- Report any changes in your health condition
- Notify us of any previous chiropractic care
Appointment Management
- Arrive on time for appointments
- Provide 24-hour notice for cancellations
- Follow the agreed-upon treatment plan
- Make timely payments for services
Safety and Compliance
- Follow health and safety instructions
- Respect clinic policies and procedures
- Treat staff and other patients with courtesy
- Provide accurate insurance and billing information
Acknowledgment
I have read and understand my rights and responsibilities as outlined above.
Patient Name: _________________
Date: _________________
Signature: _________________