Statement of Patient Rights & Responsibilities
The radiation therapy facility, at which you are receiving treatment, provides impartial access to treatment that is medically indicated regardless of race, creed, sex, national origin or religion. As a patient, you will be provided considerate, respectful, and safe care at all times with recognition of your personal dignity.
- Your right to privacy and confidentiality will be protected. Your records are treated confidentially, and except when required by law, patients are given the opportunity to approve or refuse their release.
- You, or your legally authorized representative, have a right to obtain from the attending radiation oncologist responsible for your care, information concerning your treatment and any known prognosis.
- You have a right to participate in decisions involving your care. You will not be subjected to any procedure without your voluntary consent by your legally authorized representative.
- You have a right to refuse treatment, or to stop treatment at any time.
- You may be offered a chance to participate in experimental treatment studies. If so offered, you have the right to refuse participation without consequence. You can elect not to participate in experimental studies at any given time.
- You have the right to inquire as to the estimated charges for treatments and tests prior to receiving such treatment.
- You have a right to receive a detailed explanation of your bill for the treatment services provided.
- You have the right to make a complaint, or recommend changes in facility policies and services, by writing to the Administrator of the facility at which you received treatment. In no way shall such complaints or recommendations affect the quality of your care.
- As a patient, you have the right to know facility rules and responsibilities that apply to your conduct as a patient.
- As a patient, you have the right to change radiation oncology physicians, and seek referral for radiation oncology services elsewhere.
- As a patient, you have the right to appropriate assessment and management of pain.
- You have the right to authorize the use and disclosure of your protected health information for certain purposes (not related to treatment, payment for insurance purposes and healthcare operations) and for psychotherapy notes.
- You have the right to receive a copy of the practice’s Notice of Privacy Practices.
- You have the right to request restrictions on certain uses and disclosures of your protected health information.
- You have the right to request restrictions on how the practice communicates your protected health information to you.
- You have the right to inspect and copy your protected health information.
- You have the right to request an amendment of your protected health information.
- You have the right to an accounting of the disclosures of your protected health information made by this practice for purposes other than treatment, payment for insurance purposes and healthcare operations and not in accordance with a vaIid authorization.
- You have the right to complain about alleged violations to this practice and to the Department of Health and Human Services.
- As a patient, you have the right to file a grievance with the Composite State Board of Medical Examiners concerning the physician, staff, office, and treatment received. You should either call the board with such a complaint or send a written complaint to the board. You (the patient) should be able to provide the physician or practice name, the address, and the specific nature of the complaint.
As a patient, you have the responsibility to:
- Follow rules and regulations concerning patient care and conduct.
- Be considerate and respectful of other patients and staff.
- Be respectful of the property of other persons.
- Provide to the best of your knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to your health.
- Report unexpected changes your condition to your physician.
- Report whether you clearly understand your treatment plan and what is expected of you.
- Follow the instructions of the doctors, nurses, therapists and other medical providers by following their instructions and medical advice. Be responsible for your actions and accept consequences if you refuse treatment or care, or if you do not follow your physician’s instructions.
- Cooperate with your treatment staff. If you have questions or disagree with your treatment plan, you are responsible for discussing your concerns with your treatment staff.
- Recognize that you, as the patient, are responsible for your bill and any additional charges owed to other providers for their professional services.
- Report to all of your scheduled diagnostic or treatment appointments on time. If you are unable to keep your appointment, notify the appropriate radiation therapy center as soon as possible.
- Understand that patients who are uncooperative, rude, disorderly or disruptive are subject to the loss of the privilege to receive health care at our facilities. Incidents of disruptive patients will be documented by appropriate staff and will be referred for appropriate action.
- Understand if you have signed an advance directive (living will), that Radiation Oncology Services, Inc. does not honor these objectives. Should an emergency arise while you are at our facility, we will call 911, and you will be transported to the nearest hospital.