Patient Bill of Rights
You Have the Right to:
1. Be treated with dignity, respect and privacy in all phases of your care and treatment.
2. Expect all communications and records will be kept confidential and only released with your written consent as required by law or third party payment contract.
3. Receive high quality comprehensive family planning and related services provided by qualified people.
4. A clear, concise explanation, in terms easily understood, of all proposed procedures, probable risks and benefits, alternatives, and serious side effects.
5. Be informed of any medical condition and its treatment plan.
6. Receive all information necessary in order to give informed consent or refusal for any particular drug, device, test, procedure or treatment.
7. Have input into all phases of the care and treatment performed.
8. Be provided with education and counseling on all aspects of reproductive health and related concerns.
9. Be referred or informed for other needed or desired services not available through the agency.
10. Be informed of all services available through the agency.
11. Be informed of relevant clinic policies and procedures, including charges for services and eligibility for third party reimbursement.
12. Be informed of provisions for off-hour and emergency coverage.
13. Know the names of the agency staff.
14. Be provided with an interpreter if you do no speak English.
15. Evaluate the effectiveness of the clinic.
16. Voice grievance and recommend service and policy changes to the staff and the governing body.
17. Have complaints handled efficiently and in a timely fashion.
18. Expect the agency to behave as a consumer advocate.
19. Refuse to participate in any experimental research.
You Have the Responsibility to:
1. Give truthful information.
2. Ask questions about anything you don’t understand or about which you are concerned.
3. Be aware of possible side effects of any procedures or treatment and inform the agency immediately if you suspect any serious side effects or complication.
4. Keep appointments or notify the agency in advance if you are unable to keep them.
5. Understand your chosen method of contraception and use it responsibly according to the instructions.
6. Pay what you honestly can of any fees charged for services provided.
7. Treat the agency staff with courtesy and respect.
8. Accept the recommended education, lab testing, and medical information services available that enable you to become enrolled in the Family Planning Program.