The patient has the right to:
1. Receive services without regard to age, race, color, sexual orientation, religion, marital status, sex, national origin or sponsor.
2. Be treated with consideration, respect and dignity including privacy in treatment.
3. Be informed of the services available and applicable charges at the Center.
4. Be informed of the charges for services, eligibility for third-party reimbursements and, when applicable, the
availability of free or reduced cost care.
5. Be informed of the provisions for after hours and emergency care.
6. Receive an itemized copy of his/her account statement, upon request.
7. Obtain from his/her Health Care Provider, or the Health Care Practitioner’s delegate, complete and current
information concerning his/her diagnosis, treatment and prognosis in terms the patient can be reasonably
expected to understand.
8. Receive from his/her Physician information necessary to give informed consent prior to the start of any
non-emergent procedure or treatment or both.
9. Refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of
10. Refuse to participate in experimental treatment.
11. Voice grievances and recommend changes in policies and services to the Center’s staff, The Operator and
the New York State Department of Health without fear of reprisal.
12. Express complaints about the care and services provided and to have the Center investigate such
complaints. If the patient is not satisfied by the Center’s response, the patient may complain to the New
York State Department of Health’s Metropolitan Area Regional Office (MARO) at 800 804-5447.
13. Privacy and confidentiality of all information and records pertaining to the patient’s treatment.
14. Approve or refuse the release or disclosure of the contents of his/her medical record to any Health Care
Practitioner and/or Health Care Facility except as required by law or third-party payment contract.
15. Access their medical record pursuant to the provisions of the law.
16. To Execute an Advance Directive and/or Health Care Proxy and
17. To receive pain management services.
The patient has the following responsibilities:
1. To provide the Center with complete and accurate information to the best of his/her ability about his/her
health, any medications, including over the counter products and dietary supplements and allergies or
2. To ask all questions you may have regarding the treatment provided by the Center.
3. Provide a responsible adult to transport him/her home from the facility and if required by his/her
provider, remain with him/her for 24 hours.
4. To consent by free will to all procedures.
5. Inform his/her provider about any living will, medical power of attorney, or other directive that could affect
6. To tell us if you do not understand procedures or instructions.
7. To follow after-care instructions as recommended by the Center.
8. To contact his/her Physician with post-testing questions or concerns.
9. To provide all necessary information regarding third-party payment sources.
10. Accept personal financial responsibility for any charges not covered by his/her insurance.
11. To observe all the Center’s Policies and Regulations.
12. To keep appointments as scheduled, or advise the Center if the appointment cannot be kept.
13. To be considerate of other Patients and Personnel and respect the property of others and the Center