top of page

Patient Rights and Responsibilities

Patient Rights

​

  1. You have the right to dignified and respectful care.

  2. You have the right to know about and understand your physical condition.

  3. You have the right to obtain any information requested by you to give informed consent before any treatment and/or procedure.

  4. You have the right, at your own expense, to consult with another physician or specialist,

  5. You have the right to refuse treatment, as permitted by law, and to be informed of the consequences of your refusal.

  6. You have the right to be treated in a safe environment that is free of physical and psychological threats.

  7. You have the right to privacy regarding visitors, mail, and/or telephone conversations.

  8. You have the right to expect that all communications and records regarding your care will be held confidential.

  9. You have the right to expect continuity of care and that you will not be discharged or transferred to another facility without prior notice.

  10. You have the right to communicate verbally or in writing with anyone outside the practice and to expect that an interpreter will be provided if language is a barrier.

  11. You have the right to know the identity, professional status, and institutional affiliation of anyone treating you.

  12. You have the right to request an itemized statement of all services provided to you through this practice.

  13. You have the right to be informed of all practice rules and regulations governing your conduct as a patient and to understand the procedure for registering a complaint.

  14. You have the right to treatment or accommodations required by your medical condition regardless of race, creed, sex, or national origin.

 

Patient Responsibilities

​

  1. You are responsible for providing complete information about your health and for reporting the effects of your treatment.

  2. You will be responsible for participating in the development of your plan of care.

  3. You will be responsible for attending scheduled therapy and participating in activities prescribed by your treatment plan.

  4. You will be responsible for considering the rights of other patients and office personnel during your treatment in this practice.

  5. You are responsible for following practice rules and regulations.

 

Concern/Complaint Procedure

​

We want to hear from you if you have any concerns, complaints, or compliments regarding your stay treatment and care in our practice. Please inform any staff member. Response to a concern/complaint will take place within 24 hours. Concerns/complaints will be monitored and the information utilized to improve our program.

 

I have been made aware of my rights and responsibilities and the concern/complaint procedure.

 

HIPAA—Patient Privacy Notice

 

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THE INFORMATION CAREFULLY.

​

  • Your confidential healthcare information may be disclosed to other healthcare providers for the purpose of providing you with a continuum of quality healthcare.

  • Your confidential healthcare information may be disclosed to your insurance provider for the purpose of receiving payment for providing you with healthcare services.

  • Your confidential healthcare information may be disclosed to public official or law enforcement agencies in an investigation in which you are a victim of abuse, a crime or domestic violence.

  • Your confidential healthcare information may be disclosed to other healthcare professionals in the case of a healthcare emergency.

  • Your confidential healthcare information may be disclosed to public health organizations or federal organizations in the matter of communicable diseases, defective devices, or a food or medication reaction.

  • Your confidential healthcare information cannot be disclosed for purposes other than those, which are outlined in this notice.

  • Your confidential healthcare information may only be disclosed after receiving written authorization from you. You have the right to revoke your permission to disclose confidential healthcare information at any time.

  • You may be contacted by office personnel to remind you of appointments, healthcare treatment options or other health services that may be of interest to you.

  • You have the right to restrict the use and disclosure of your confidential healthcare information to family members, friends, or others involved in your healthcare or payment for health care services. However, the physician office may choose to refuse your restriction if it is in conflict of providing you with quality healthcare or in the event of a medical emergency.

  • You have the right to receive confidential communication about your healthcare status.

  • You have the right to review and request a copy of any and/or all portions of your healthcare information.

  • You have the right to request changes be made to your healthcare information.

  • You have the right to have a copy of this Privacy Notice upon request.

  • The physician office is required by law to protect the privacy of its patients.

  • The physician office will abide by the terms of this notice. We reserve the right to make changes to this notice and continue to maintain the confidentiality of all healthcare information.

  • You have the right to complain to the Privacy Officer of this office and to the Secretary of Health and Human Services if you believe your rights to privacy have been violated. If you feel your privacy rights have been violated, please mail your complaint to:

 

Attn: Toni Adame

Forefront Behavioral Health

2911 Medical Arts St #8

Austin, TX 78705

 

All complaints will be investigated. No personal issue will be raised for filing a complaint with the physician office. For further information about this Privacy Notice, please contact the Privacy Officer at (512) 580-2323.

​

bottom of page