Vanderbilt Comprehensive Care Clinic

Patient Rights and Responsibilities

The Vanderbilt Comprehensive Care Clinic provides considerate, respectful, and dignified care to all clients without regard to age, race, sex, handicap, religious beliefs, national origin, sexual orientation, or source of payment for treatment.

In addition, the Vanderbilt Comprehensive Care Clinic affirms that all civil rights, including those regarding freedom from discrimination based on age, HIV infection or AIDS, and handicaps are protected under Title VI of the Civil Rights Act of 1964, the Age Discrimination Act (ADA) of 1975, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act.

Your rights and responsibilities shall include, but are not limited to:

1. Considerate and respectful care, with dignity, at all times;
2. Impartial access to care, regardless of ability to pay;
3. The right to refuse treatment on religious or other grounds;
4. Active participation in decisions regarding your care;
5. Involvement in all aspects of your care. This includes the right to be informed of the:
a. Diagnosis;
b. Prognosis;
c. Appropriate treatment options and their risks, benefits, alternatives, consequences of no treatment, and the results of care including any unanticipated adverse outcomes.
6. Prompt notification of a family member or representative of your choice for emergencies.
7. Your right to know the identity, professional status, role, and business relationship of all who participate in your care;
8. The right to refuse to see or talk with anyone not directly involved in your care or not acting in an official capacity as a representative of the clinic;
9. The right to examine and receive an explanation of all bills regardless of source of payment;
10. Access to an interpreter, at no cost to you, if you do not speak or are not fluent in English;
11. Access to auxiliary assistance, devices, or animals as necessary if you are hearing, speech, or visually impaired;
12. The right to wear appropriate personal clothing, religious, cultural, or other symbolic items, which do not interfere with prescribed treatment or procedures;
13. The right to personal privacy and confidentiality of your personal health information;
14. The right to review and/or obtain copies of medical and financial records;
15. The right to request and receive a list of certain disclosures of your protected health information made in accordance with Tennessee and federal laws;
16. The right to request an amendment to your records if your believe information is inaccurate or incomplete;
17. The right to request restrictions on how your medical and financial records are used and disclosed.
18. The right to request that the Comprehensive Care Center communicate with you at an alternative phone number or address;
19. The right to be examined with reasonable regard to your privacy in an area where others may not see or hear, including the right to request a person of one's own gender present during physical examinations;
20. The right to the security and freedom from search and/or seizure of personal belongings except for reasonable cause;
21. The right to receive care in a safe setting;
22. Freedom from the use of restraints or seclusion in the provision of your care unless clinically necessary;
23. The right to appropriate assessment and management of pain;
24. The right to have your instructions followed pertaining to Living Will and Durable Power of Attorney for health care;
25. The right to expect plans for reasonable continuity of care so that continuing health care needs may be met.

B. Your responsibilities include:

1. The provision of accurate information about your present health condition and past medical history, including current and accurate contact and insurance information;
2. Adherence to your prescribed treatment plan;
3. Acceptance of personal responsibility for refusing treatment;
4. The provision of a copy of your Advance Directives (Living Will and Durable Power of Attorney for health care);
5. Your attention to clinic rules;
6. Your recognition of the rights of other patients and families;
7. Your fulfillment of financial obligations;
8. Your acknowledgement that you have received our Notice of Privacy Practices;
9. Advising staff when you have any specific privacy concerns.

To file a complaint with the Secretary of the Department of Health and Human Services:

Region IV, Office for Civil Rights
U.S. Department of Health and Human Services
Atlanta Federal Center
61 Forsyth Street, SW, Suite 3B70
Atlanta, GA 30303-8909
Telephone: (404) 562-7886. FAX (404) 562-7881. TDD (404) 331-2867

Version 3/25/04

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