Patient Consent for Services
Patients Rights & Responsibilities
Alexander Valley Healthcare is committed to providing high-quality, cost-effective health care to the people we serve. We believe that every patient deserves to be treated with respect, dignity, and concern. We will provide care regardless of race, creed, sex, national origin, or source of payment.
We consider you a partner in your health care. When you are well informed, participate in treatment decisions, and communicate openly with your doctor and other health professionals, you help make your care as effective as possible. Alexander Valley Healthcare encourages respect for the personal preferences and values of each individual. It is our goal to assure that your rights as a patient are observed and to act as a partner in your decision making process.
While you are a patient at Alexander Valley Healthcare, you have the following rights:
Access to Care
- To exercise these rights without regard to gender, sexual orientation, culture, economics, education, religion, language, age, race, color, ancestry, national origin, presence of a disability, or the source of payment for your care.
- To obtain a reasonable response to any reasonable request made for services within the health center’s capacity, stated mission, applicable laws, and regulations. The health center will give each patient necessary health services to the best of its ability, including choice of clinician.
- To appropriate access to emergency services.
Considerate and Respectful Care
- To considerate, respectful care and treatment that optimizes your comfort and dignity.
- To appropriate care which reflects your desires, or that of a legal representative (surrogate decision maker), while acknowledging physical limitations, psychosocial, spiritual, and cultural concerns.
- To reasonable continuity of care and knowledge in advance of the time and location of future appointments, as well as the identity of the persons providing that care.
Knowledge and Information
- To have knowledge of the name of the clinician who has primary responsibility for coordinating your care and the names and professional relationships of other health professionals who will see you.
- To receive information from the clinician about your care and treatment in terms that you can understand.
- To receive as much information about any proposed treatment or procedure as you may need in order to give informed consent or to refuse this course of treatment.
Active Participation in Their Care
- To actively participate with your clinician in making decisions regarding your care. Your designated representative also has this right.
- To formulate advance directives.
Privacy and Confidentiality
- To full consideration of privacy concerning your care and treatment. Your visit, discussion, consultation, examination and treatment are confidential and will be conducted discreetly.
- To confidential treatment of all information, communications, and records pertaining to your care and treatment. Written permission from you or your legally designated representative shall be obtained before medical records can be made available to anyone not directly concerned with patient care. You or your legally designated representative are entitled to access the information contained in your medical record, within the limits of the law.
Respect for Patient Rights
- To express concerns or complaints about your care with the assurance that the presentation of a complaint will not compromise the quality of your care or future access to care and to expect a reasonable and timely response to your concerns.
- To expect that all Alexander Valley Healthcare personnel shall observe these patient rights and that all patient rights apply to the person who may have legal responsibility to make decisions regarding medical care on your behalf.
- Receive information about Advanced Directives.
While you are a patient at Alexander Valley Healthcare, you have the responsibility to:
- Provide your doctor with accurate and complete health information
- Let your doctor know that you understand the medical procedures and what you are expected to do.
- Be considerate and respectful of others, both patients and staff.
- If you do not follow your clinician’s plan or if you refuse treatment, you must accept responsibility for your actions.