You have the right to receive treatment from this agency in an atmosphere of dignity and to be shown respect by all agency personnel.
You have the right to know and be involved in the formulation of your individualized treatment plan and the goals to be attained through this treatment.
You have the right to know what unreasonable risks, if any, are involved in treatment and whether or not the treatment will include any new or experimental techniques or medications.
You have the right to refuse treatment unless your involvement with this agency has been ordered by a Court of Law.
You have the right to know that your records and information regarding your treatment will be maintained with the utmost confidentiality in accordance with the rules and regulations governing same and that no clinical information will be released to any third party unless you agree by signing the appropriate release forms. The only exception to this will be an order by a Court of Law or duly authorized office of the Court, or in case of extreme emergency situations.
You have the right to know the cost to you of your treatment, if any, as well as the amount that will be billed to a third party payer, if any.
You have the right to make your grievances known to the agency via the following procedures. The first level of appeal is to your therapist or Medical Clinic Coordinator. The second level is to the Clinical Director. The third level is the Executive Director.
You are expected to meet any financial expectations incurred in treatment. If you have difficulties in this area, please discuss them with your therapist.
You are expected to notify your therapist of changes of address, phone number, income, or medical insurance.
Please treat staff and other consumers with courtesy and respect, and expect to be treated in a similar manner.
Please respect all furniture, equipment, and property. Be familiar with and follow all smoking regulations. The smoking regulations are here for your safety as well as the health of other people with whom you share this building. Please be familiar with fire exits and fire evacuation procedure.
All aspects of your treatment here are confidential and will not be disclosed to outside agencies without your written authorization. You are expected to maintain the confidentiality of information you hear in treatment regarding other consumers. Please do not discuss information with other consumers in treatment at the agency. Whatever is discussed in a group should not be discussed outside of that group if it makes mention of a specific person. Please be sensitive to the privacy of others.
Please report all medication you take to the doctor.
Some medication may be dangerous in pregnancy. Any woman who is pregnant, or plans to become pregnant, should discuss this with the doctor.
Please keep all schedule appointments with our providers. Notify your doctor of any undesirable side effects from your medication, or of any changes that you yourself have made to the medication.