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Your Patient Rights
[Hospital may provide new or modify this information.] You have rights and a role regarding your treatment and care. Knowing your rights
and role can help you make better decisions about your healthcare.
• You have the right to be informed about the care you will receive.
• You have the right to get important information about your care in your preferred language.
• You have the right to get information in a manner that meets your needs, if you have vision, speech, hearing or mental impairments.
• You have the right to make decisions about your care.
• You have the right to refuse care.
• You have the right to be listened to.
• You have the right to know the names of your caregivers.
• You have the right to safe care.
• You have a right to have your pain addressed.
• You have the right to care that
is free from discrimination.
is means you should not be treated di erently because of age, race, ethnicity, religion, culture, language, physical or mental disability,socioeconomicstatus, sex, sexual orientation, gender identity or expression.
• You have the right to know if something goes wrong with your care.
• You have the right to get a list of all your current medicines.
• You have the right to be treated with courtesy and respect.
• You have the right to have a personal representative, also called an advocate, with you during your
care. Your advocate can make decisions for you if: ey are your legal guardian or if you signed a legal document giving them the power to make decisions for you. is document may be called a Healthcare Power Of Attorney. Ask if there is a form to name your advocate and about your state’s laws regarding advocates.
• Ask for written information about all of your rights as a patient.
• Youhavearighttoprivacy. Healthcare providers must keep some details about your health private. You can sign a form if you want healthcare providers to share information with others.
If You have questions about your patient rights and responsibilities, call Ext. 1234.
Your Patient Responsibilities
• Be an active participant in your healthcare. You are a member of your healthcare team.
• Ask questions. If you don’t understand any part of your care plan, your procedures, your medications or any instructions, ask your healthcare providers to explain until you do understand.
• Pay attention to instructions given to you by caregivers and follow your care plan.
• Share information about your health with your caregivers. For example, give them a list of your medicines including supplements. Remind them about any allergies you may have. Report any pain to your healthcare team.
• Be respectful and considerate of other patients and sta .
• Know the terms of your insurance and ful ll your nancial obligation to the hospital as promptly as possible
Informed Consent
[Hospital may provide new
or modify this information.] Informed consent means that
you understand your treatment choices and risks. You should understand the treatment choices, their risks, as well as the risks of non-treatment. Informed consent isrequiredforexperimental treatments.
• Hospitalscantakepictures, videos, or other images and recordings to be used for your care or treatment, or to identify you. e sta must ask your permission to use the images
or recordings for any other purpose.
• Ifsomethinggoeswrongwith your care or treatment, you have the right to an honest
explanation and an apology within a reasonable amount of time.
Filing A Complaint
• Contactthestateagency that licenses or certi es the healthcare facility. (See next page for your state agency.)
• Callthehealthcarefacilityor health system so that they can correct the problem. (See next page for this information.)
• Contact eJointCommission with complaints about their accredited organizations. (See next page.) You can also ll out a complaint form at www. jointcommission.org/report acomplaint.aspx.
Information obtained from e Joint Commission and Centers for Medicare & Medicaid Services
YOUR PATIENT RIGHTS & RESPONSIBILITIES