You, our patient, have the right to:
- Be afforded considerate and respectful care in a safe environment, and free from mental, physical, sexual and verbal abuse, neglect and exploitation.
- Medical care without discrimination as to race, religion, national origin, sex or sexual orientation, disability, source of payment or age.
- Be fully informed, in layman’s terms, concerning your health, diagnosis, treatment options and prognosis. You have the right to helpful information and answers to your questions.
- Make decisions about your care and to include or exclude family members or others when making decisions.
- Be furnished with the name of the provider(s) and staff helping with your care.
- Accept or refuse any treatment by the clinic to the extent permitted by law and to be informed of the medical consequences of such acceptance or refusal.
- Designate a representative to make healthcare decisions on your behalf.
- Privacy, which shall be respected to the extent consistent with providing adequate medical care to you, with the efficient administration of the clinic and with applicable law.
- Discuss concerns you may have when, from time to time, your provider may ask another provider,medical assistant or a medical student to accompany them in the exam room.
- Change providers or transfer your care.
- Refuse to participate in any research program should one be offered.
- Examine your bill and receive an explanation of the charges, regardless of the source of payment of such bill. An itemized bill will be furnished upon request.
- Review your medical record, and obtain a copy for a reasonable fee.
- Be involved in your care.
- Have any concerns, complaints and grievances heard and addressed without fear of reprisals.
- Have the right to request a chaperone.
You, our patient, have the responsibility to:
- Provide VITAE I.M.C. with correct and complete information about past illnesses, hospitalizations, medications, allergies and any other matters relating to your health.
- Inform VITAE I.M.C. if you do not understand information or instructions given to you by the staff or if you think you will be unable to carry out any particular instruction.
- Report any unexpected changes in your condition or concerns about your care.
- Follow the care, treatment and service plans developed for you by your healthcare team.
- Keep all appointments and advise VITAE I.M.C. when you are unable to keep an appointment.
- Arrive 15 minutes prior to your scheduled appointments to allow time for the review of any paperwork or visit-related information.
- As a courtesy to others, you will likely be rescheduled if you arrive at VITAE I.M.C past your scheduled appointment time.
- Repetitive cancellations, no-shows or lateness may result in discharge from the clinic.
- Be considerate of other patients, their visitors and their property.
- Be considerate of VITAE staff and our property. Please note that we have a zero tolerance policy regarding any verbally, physically or mentally abusive or threatening behavior to any VITAE staff, providers or other patients. Such behaviors will be grounds to terminate your care and therapeutic relationship with VITAE.
- Share any concern you may have if your provider asks another provider, medical assistant or medical student to accompany them in the exam room. This would occur when the provider requires support and/or we have a student training at our clinic.
- Schedule an appointment for all medication refills
- Provide complete and sufficient information necessary for insurance processing of your bill.
- Assume the financial responsibility of paying for all services rendered either through your insurance or by taking personal responsibility to pay for any services that are not covered by insurance.
I have read and understand the above policies.