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YOUR RIGHTS AS A PATIENT

Notice of Privacy Practices Consent Form Acknowledgement of Notice Printer Friendly Version

When you are well informed, participate in treatment decisions , and talk openly with your doctor and office staff, then you help make your care more effective.

PATIENT RIGHTS-YOU HAVE THE RIGHT TO:

  • Considerate, respectful, and safe care.

  • A discussion of your illness, what we can do about it, and the likely outcome of care.

  • Know the names and roles of the PEOPLE caring for you here.

  • Respectful and effective pain management.

  • Receive as much information to consent to or refuse a course of treatment or invasive procedure and to actively participate in decisions regarding your medical care.

  • Involve your health care proxy or significant others in the decision making process for medical decisions.

  • Reasonable continuity of care and to know in advance the time and location of an appointment as well as the doctor you are seeing.

  • Full consideration of privacy and confidentiality of your medical information. Your written permission will be obtained prior to releasing any medical information. When we do release your information to others, we ask them to keep it confidential.

  • Review your medical record and ask questions unless restricted by law.

  • Know of any relationships with other parties that may influence your decision.

  • Know about rules that affect your care and about charges and payment methods. You have a right to receive and examine an explanation of your bill regardless of the source of payment.

  • Voice your concerns, complaints, or problems with the care you received by contacting our office manager.

PATIENT RESPONSIBILITY-YOU AGREE TO: 

  • Provide accurate and complete information concerning your symptoms, past history, and current health status.

  • Make known whether you clearly comprehend your medical care and what is expected of you in the plan of care.

  • Follow the treatment plan and care instructions given to you.

  • Keep appointments and notify us if you are unable to do so.

  • Accept responsibility for your actions if you refuse planned treatment or do not follow your doctor's orders.

  • Accept financial responsibility for care received and pay promptly.

  • Follow facility policies and procedures.

  • Be considerate of the rights of other patients and staff.

  • Be respectful of your personal property and of others in the facility.

  • Inform the staff of any discomfort or pain and patient safety issues.

  • Share your values, beliefs, and traditions to help the staff provide appropriate care.

 
Notice of Privacy Practices Consent Form Acknowledgement of Notice Printer Friendly Version

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2041 Valley Gate Drive, Fayetteville, NC 28304


 

 

Phone: (910) 323-5203

Fax (910) 323-3650