Patient Rights and Responsibilities

As a patient, you have the right to:

• Take part in your health care and treatment
• Know the names of the people caring for you
• Be treated with respect and dignity in a safe and private setting
• Be informed about your illness and treatment, including options for your care
• Change medical providers at Family Health Source
• Get another opinion about your illness or treatment
• Privacy of your health records
• Talk with the clinic about any questions or problems with your care
• Know about services available through Family Health Source
• Respect for your cultural, social, spiritual, and personal values and beliefs
• Know about legal reporting requirements
• Ask for special arrangements if you have a disability
•  Ask for help with a living will or durable power of attorney for health care
• Refuse treatment, care, and services as allowed by law
•  Know the cost of your care and ways you may pay for your care
•  Refuse to be included in any research program without limiting medical care or treatment

As a patient, you have the responsibility to:

• Tell your medical provider about your illness or problems
• Ask questions about your illness or care
• Show respect to both caregivers and other patients
• Cancel or reschedule appointments so that another person may have that time slot
• Pay your bills on time
• Use medications or medical devices for yourself only
• Inform the medical provider if you become worse or you have an unexpected reaction to a medication
• Give written permission to release your other health records to Family Health Source when necessary
• Provide Family Health Source a copy of your living will or durable power of attorney for healthcare matters If you have any questions, please tell your medical provider