Attachment 2 - PATIENT RIGHTS AND RESPONSIBILITIES.docx

PATIENT RIGHTS AND RESPONSIBILITIES

Patients’ Rights and Responsibilities Document The VA Medical Center is dedicated to providing quality and excellence in patient care, education and research.

As a patient you have the right to:

· Healthcare that respects your personal value and belief systems regardless of race, sex, national origin, age or sources of payment for care.

· Fast and correct care with the least change in lifestyle for that treatment.

· Make decisions about your care

· Reasonable protection of your privacy.

· To have your medical and personal information released as you choose or as needed by law.

· Choose a person to make medical decisions for you if you become unable to make choices.

· Choose not to be treated within the limits of the law.

· Express a complaint and receive fast attention.

· Know what hospital rules and regulations apply to you.

In providing your care, the VA Healthcare System has the right to expect reasonable and responsible behavior on the part of patients and visitors. Compliance with the following list of responsibilities is necessary to ensure you the highest quality care. You are responsible to:

· Follow all of the medical center's safety rules and posted signs

· Be considerate and respectful of medical center personnel and other patients.

· Cooperate with your treatment staff. If you have questions or disagree with your treatment plan, you are responsible for discussing it with you treatment staff.

· Prevent any injury to yourself, other patients, visitors and staff members of your own actions and to be responsible for the safekeeping of clothing, money, and personal possessions you chose to keep with you while you are in this medical center.

· Keep all your scheduled diagnostic or treatment appointments all the time.

· Make sure you understand what medications you are prescribed.

· Make sure you understand clinic follow up appointments.

As a patient receiving home oxygen equipment and/or devices you have the responsibility to:

· Take reasonable care when using devices and/or equipment issued to you.

· Exercise reasonable care and maintenance of devices and equipment issued to you.

· Express your concerns regarding the timeliness of services and devices provided to you.

· Complete and have placed on file a copy of your Patient Satisfaction Form clearly stating your questions and concerns.

· Immediately advise the Prosthetic Service of defective equipment.

· Advise the Prosthetic Treatment Center when equipment is no longer required for your use.

· Not to sell or give away equipment provided to you by the Department of Veterans Affairs.

(Print Name) hereby acknowledged receipt of a copy of the Patient Rights and Responsibilities document.

Patient's or Caregivers Signature Date