Statement of Clients’ Rights

 

Clients have the right to:

·         Be treated with dignity and respect.

·         Fair treatment; regardless of race, religion, gender, ethnicity, age, sexual

          orientation, disability, or source of payment.

·         Have treatment and other client information kept private. Only where

          permitted by law, may records be released without client permission.

·         Easily access timely care.

·         Know treatment choices regardless of cost or coverage by insurance plan.

·         Share in developing treatment plan.

·         Information in understandable language.

·         A clear explanation of condition and treatment options.

·         Information about Capstone, its practitioners, services, and role in 

          treatment process.

·         Information about clinical guidelines used in providing and managing care.

·         Ask provider about their work history and training.

·         Give input on this statement.

·         Know about advocacy and community groups and prevention services.

·         Freely file a complaint or concern and learn how to do so.

·         Know rights and responsibilities in treatment process.

·         Receive services that will not jeopardize employment.

·         Request certain preferences in a provider.

·         Have provider decisions about their care made without regard to financial

          incentives.

Statement of Clients’ Responsibilities

 

Clients have the responsibility to:

·         Treat those giving care with dignity and respect.

·         Give providers information they need so they may deliver the best possible

          care.

·         Ask questions about care to assist in understanding care.

·         Follow the treatment plan. The plan of care is to be agreed upon by the

          client and provider.

·         Tell provider about medication changes.

·         Keep appointments. Call the provider as soon as possible if cancellation or

          rescheduling is necessary.

·         Let the provider know when the treatment plan is not working.

·         Report abuse and fraud.

·         Let the provider know about problems with paying fees.

·         Openly report concerns about the quality of care being received.

My signature below shows that I have been informed of my rights and responsibilities, and that I understand this information.