You have the right to…
Be treated with dignity and respect
You (as well as your property) have the right to be treated with dignity and respect by every member of our team. You have the right to treatment that is based on you as an individual and free from prejudice; stereotypes; discrimination; harassment; verbal, emotional, physical, or sexual abuse; mistreatment, and neglect.
Understand the services being provided and by whom
You have the right to know, at the beginning of treatment, what service(s) you are getting, the scope of the services, and the anticipated frequency of that service(s). You can be a part of the creation and revision of your treatment plan. You have the right to request for proof of Graceland Psychiatry personnel through proper identification
Understand Privacy and Confidentiality
You have the right of confidentiality in your treatment and privacy of your medical record. Your case information will be shared with treatment team members only for the purpose of providing you with optimal treatment. All of your private medical information will be kept in your private medical file. You should know that there are instances where we can’t maintain your confidentiality. Those instances include:
- When you are a danger to yourself
- When you are a danger to another identifiable person
- When your records have been subpoenaed by a judge
- When you disclose abuse or neglect of you as a child or vulnerable adult
- When you disclose that you are an abuser or neglector of a member of a vulnerable population
Understand how to fund your treatment
You can know the fees associated with your services, how much of your treatment costs will be covered by third parties like insurance companies, and the portion of your treatment costs for which you may be responsible.
Know how referrals are managed financially
You should know that we receive no monetary (or other) incentive when we refer to other professionals or agencies.
Get an electronic or paper copy of your medical record
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable fee for administrative duties like photocopying.
Ask us to correct your medical record
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
You have the right to refuse or end services at any point during your treatment. If you elect to refuse or end treatment, the consequences of that decision will be shared with you. Graceland Psychiatry may terminate treatment in a healthy way and offer referral options based on your refusal to engage in treatment.
Ask us to limit what we use or share
You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, with whom we shared it, and why. We will include all the disclosures for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable fee if you ask for another one within 12 months.
Get a copy of this notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
Express concerns or grievances
You have a right to express your concerns about your treatment, the treatment of your property, or other grievances to your therapist and/or the practice manager in writing or verbally. The Graceland Psychiatry team member is required to pass your concerns/grievances onto his/her supervisor, according to our policies and procedures.
Appeal decisions made by the Grievance Committee
You have a right to request an appeal of the Grievance Committee.
As the patient, you are responsible for…
- Providing accurate and complete information about medical complaints, past illnesses, hospitalizations, medications, pain, and other matters relating to your health.
- Following the treatment plan recommended by those responsible for your care.
- Being considerate in language and conduct of other people and their property, including being mindful of noise levels, privacy and number of visitors while on Graceland Psychiatry premises.
- Leaving your valuables at home.
- Accepting the consequences should you refuse treatment or do not follow the healthcare team’s instruction.
- Seeing that your bills are paid as promptly as possible.
- Reporting unexpected changes in your health.
- Being considerate of the rights of other patients and Graceland Psychiatry personnel.
- Avoiding the creation of pictures, videos, and/or recordings without permission from Graceland Psychiatry personnel being in control of your behavior at all times while on Graceland Psychiatry premises.
- Adhering to Graceland Psychiatry policies and procedures outlined in the informed consent document.
- Asking questions and seeking information if there is something you don’t understand.