Patient Rights
Access to Care
- Right to receive appropriate medical care regardless of race, religion, national origin, or ability to pay
- Right to be treated with respect and dignity by all staff members
- Right to receive care in a safe, child-friendly environment
Information and Communication
- Right to receive complete, current information about diagnosis, treatment, and prognosis
- Right to have medical information explained in understandable terms
- Right to access medical records as permitted by law
- Right to privacy and confidentiality of all medical information
Treatment Decisions
- Right to participate in healthcare decisions affecting your child
- Right to refuse treatment within legal limitations
- Right to be informed about the consequences of refusing treatment
- Right to receive information about advance directives as applicable
Parent/Guardian Responsibilities
Communication
- Provide accurate, complete information about your child's health
- Inform healthcare providers about any changes in your child's condition
- Ask questions when you don't understand information or instructions
Compliance
- Follow the recommended treatment plan
- Keep scheduled appointments or provide adequate notice of cancellation
- Ensure all financial obligations are met as agreed upon
- Update contact and insurance information promptly
Conduct
- Treat healthcare providers and staff with respect
- Follow facility rules and regulations
- Supervise your child appropriately during visits
- Respect the rights and property of other patients
Acknowledgment
I acknowledge that I have read and understand these rights and responsibilities:
Parent/Guardian Signature: ___________________ Date: ___________
Print Name: ___________________
Relationship to Patient: ___________________
Witness: ___________________ Date: ___________