Your Rights as a Neurology Patient
Access to Care
- Receive care regardless of race, religion, gender, or source of payment
- Obtain complete information about diagnosis, treatment, and prognosis
- Access your medical records as permitted by law
- Receive emergency care when needed
Quality of Care
- Receive respectful care in a safe environment
- Participate in treatment decisions
- Refuse treatment as permitted by law
- Receive appropriate pain management
- Have your privacy protected according to HIPAA regulations
Communication
- Receive information in terms you can understand
- Access interpreter services if needed
- Know the names and roles of your healthcare providers
- Have your questions answered promptly and completely
Your Responsibilities
Providing Information
- Supply accurate and complete medical history
- Report changes in your condition
- Inform us about medications, including over-the-counter drugs
- Provide accurate insurance and payment information
Participation in Treatment
- Follow the prescribed treatment plan
- Keep appointments or notify us of cancellations
- Accept responsibility for refusing treatment
- Participate actively in your care decisions
Conduct and Payment
- Treat staff and other patients with respect
- Follow facility rules and regulations
- Meet financial obligations promptly
- Provide updated contact information
Acknowledgment
I have read and understand my rights and responsibilities as outlined above.
Patient Name: _________________
Date: _________________
Signature: _________________