RESPECT: You have the right to...
- Considerate and respectful care in an environment free of all forms of abuse or harassment.
- Know that you will not experience discrimination because of your nationality, ethnic and cultural traditions, religious preferences, or lifestyle choices.
- Personal privacy and to receive your care in a safe setting.
INFORMATION: You have the right to...
- Relevant and understandable information about your diagnosis, treatment alternatives, and anticipated outcomes.
- Know the identity of the doctors, nurses, and other professional persons who are providing your care.
- An explanation of any charges for which you may be held personally responsible.
- Access your medical record.
CONFIDENTIALITY: You have the right to...
- Expect that your medical record will be maintained in a confidential manner.
PARTICIPATION: You have the right to...
- Participate in decisions about your care, including the right to refuse a recommended treatment.
- File an advance directive for health care with the expectation that it will be honored.
- Include family members and significant other persons in your life in decisions about your care.
STANDARD OF CARE: You have the right to...
- Receive your care from professionals committed to the highest standards of quality and personal integrity.
- Be free from seclusion and physical or chemical restraints unless your medical condition necessitates restraint for the personal safety of yourself or others. Whenever restraint is necessary, the least restrictive measure will be employed.
- Continuity of care and to be informed of available and realistic healthcare options when your medical condition warrants transfer to another facility.
- Appropriate assessment and management of your pain.
PATIENT RESPONSIBILITIES: Please help us care for you by...
- Providing accurate information about your past illnesses, hospitalizations, surgeries, and current medications (including herbal therapies, vitamin supplements, or any other over-the-counter medications).
- Answering questions about your health and matters relating to your health honestly and completely.
- Asking questions if you do not understand treatment options, explanations or directions for follow-up care.
- Treating others courteously and respecting the rights of other patients by being mindful of noise and the number of visitors.
- Following the treatment plan that you and your doctors, nurses and allied medical personnel have agreed upon.
- Reviewing your health insurance guidelines and obtaining pre-authorization when necessary.
- Working cooperatively with Bellin¿s financial counselors and fulfilling your financial obligations to Bellin promptly.
- Informing your doctor if you experience unexpected outcomes or reactions.
- Accepting responsibility for your actions if you do not follow your doctor¿s instructions or an agreed upon treatment plan.
- Keeping appointments, and, when you are unable to do so, promptly notifying the appropriate office.
- Informing your doctor, nurse, or other healthcare professional promptly if you are dissatisfied with any aspect of your care at Bellin.
Bellin has a moral and legal obligation to inform you of your rights and responsibilities. Providing you with this information is part of Bellin¿s commitment to accessible, quality health care in an environment that respects open and honest communication, personal and professional values, and the special needs of each patient.
For more information about your rights and responsibilities:
Ask your doctor or nurse. You may also contact any of the following:
- Bellin Ethics Committee Chair: (920) 445-7024
- Nurse Executive: (920) 433-3602 or (920) 433-7436
- Administrator On-Call: (920) 433-3500
- Bellin Medical Group Clinics: (920) 445-7282