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PATIENT RIGHTS   Patient Rights  DECISION MAKING  •  You have the right to be informed of   Responsibilities  Patient Privacy  Request confidential communications.

 your health status, to be involved in
                                                                                 •  You can ask us to contact you in a
 •  You have the right to participate in
 the development and execution of
                                                                                   specific way (example: home or office
 your care planning and treatment,
      You have A RESPONSIBILITY TO:
 ACCESS
                                           When it comes to your healthcare
 your care plan.
 and to request or refuse treatment.
                                                                                   phone) or to send mail to a different
 •  You have the right to equal
                                           information, you have the right to:
                                                                                   address. We respond to reasonable
 •  You have the right to be involved in
 •  Your right to treatment or service is
      •  PROVIDE a complete MEDICAL
 access to care.
 all parts of the care you receive.
                                                                                   requests.
 respected and supported.
        HISTORY along with a LIST of
 •  You have the right to have a family
                                           Get an electronic or paper copy of
 member, advocate and your own
 to another hospital. If you want to
 family participate in decisions about
        and supplements and allergies.
                                                                                share certain health information
 physician notified promptly of your
                                             •  You can ask to see or get an
 be moved to another facility, we will
 your care.
 admission to the hospital.  •  You have the right to have your   •  You have the right to request transfer   your MEDICINES, vitamins, herbs   your medical record.   You can ask us not to use or
                                                                                for treatment, payment or our
                                               electronic or paper copy of your
 help you in safely transferring to that
 •  We will respect your religious,   KNOWLEDGE  healthcare facility.  •  ASK questions about your care   medical record and other health   operations.   PATIENT RESPONSIBILITIES & PRIVACY
 cultural and personal beliefs and   •  You (or your advocate) have the   •  You have the right to Pastoral     plan, procedures, medicines or   information we have about you. Ask   •  We are not required to agree to your
 traditions.  right to make informed decisions   care and spiritual services.  instructions until you understand.  us how to do this.  request, and we may say “no” if it
 •  We will not discriminate against you.  regarding your care.  •  PAY ATTENTION to and  FOLLOW   •  We will provide a copy or a summary   would affect your care.
 •  Your doctor will inform you of risks,
 COMFORT  benefits and alternatives prior to    SAFETY AND SECURITY  all doctor instructions and   of your health information, usually   •  If you pay for a service or healthcare
 •  You have the right to control your   any invasive procedures.  •  You have the right to      treatment plans and keep all   within 30 days of your request. We   item out-of-pocket in full, you can
 pain management.  •  If you are asked to participate in a   receive care in a safe setting.  doctor appointments.  may charge a reasonable, cost-based   ask us not to share that information
                                                                                   for the purpose of payment or our
 COMMUNICATION  research project, you have the right   •  You have the right to be free from   •  REPORT changes in your condition.  fee.  operations with your health insurer.
 •  You have the right to a printed copy   to be given information describing   all forms of harassment.  Ask us to correct your medical record.    We will say “yes” unless a law
 of these rights.   the expected benefits, potential   •  You have the right to a secure space.  •  BE CONSIDERATE of other patients,   •  You can ask us to correct health   requires us to share that information.
 •  You have the right to communication.   discomforts, and any alternatives   •  We will keep you safe and protect   staff and hospital property.  information about you that you
 If your mail or phone is restricted, it is   that might benefit you.   you from verbal/physical abuse.  think is incorrect or incomplete. Ask   Get a list of those with whom we’ve
 to ensure that you receive proper rest.  •  Your doctors will be truthful about   •  You have the right to access   •  PROVIDE CORRECT INSURANCE   us how to do this. We may say “no” to   shared information.
 •  You have the right to request itemized   any experimental procedures. You   protective services.  INFORMATION and work with   your request, but we’ll tell you why in   •  You can ask for a list (accounting) of
 copies of your bill, an examination   have the right to refuse to participate   •  You have the right to be free from   the hospital to pay your hospital   writing within 60 days.  the times we’ve shared your health
 and an explanation of your account   in research projects, and your care   restraints of any form that are not   bill as promptly as possible.   information for six years prior to
 regardless of your source of payment.  will not be compromised.  medically necessary.  •  ASK for help with your bill.  the date you ask, who we shared
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