Your Rights as a Patient
Medical Care Rights
- Receive appropriate medical care regardless of race, religion, gender, or economic status
- Be treated with respect and dignity by all healthcare staff
- Receive complete information about your diagnosis, treatment, and prognosis
- Participate actively in decisions regarding your surgical care
- Obtain a second opinion before any surgical procedure
- Access your medical records as permitted by law
Privacy and Safety Rights
- Have your medical information kept confidential
- Receive care in a safe and clean environment
- Be free from all forms of abuse or harassment
- Have your pain assessed and managed appropriately
Communication Rights
- Receive information in a language you understand
- Know the names and roles of your healthcare providers
- Have your questions answered clearly and completely
- Access interpreter services if needed
Your Responsibilities as a Patient
Information Responsibilities
- Provide accurate and complete medical history
- Inform staff about current medications and supplements
- Report any changes in your condition promptly
- Notify staff of any safety concerns
Treatment Responsibilities
- Follow the agreed-upon treatment plan
- Attend all scheduled appointments
- Arrange for necessary follow-up care
- Comply with pre-operative and post-operative instructions
Financial Responsibilities
- Provide accurate insurance information
- Meet financial obligations for services
- Understanding your insurance coverage
- Discuss any financial concerns with our billing office
Acknowledgment
I have read and understand my rights and responsibilities as outlined above.
Patient Name: _________________
Date: _________________
Signature: _________________