Your care

Patient Rights & Responsibilities

Care works best as a partnership. Here is what you can expect from us, and what we ask of you.

DRAFT — requires review by the practice's healthcare attorney before launch.

Last updated: [LAST UPDATED — to be supplied by the practice]

Your rights

To be treated with dignity, respect, and consideration, free from discrimination.
To receive care in a safe setting, free from abuse, neglect, harassment, retaliation, and unnecessary restraint.
To know the name, role, and credentials of every clinician involved in your care.
To a clear explanation of your evaluation, treatment options, expected benefits, risks, side effects, and reasonable alternatives — including the option of no treatment.
To give informed consent, and to refuse or withdraw from treatment.
To participate in your treatment plan and in decisions about your care.
To privacy and confidentiality of your health information under HIPAA, and to additional federal protection for substance use disorder records.
To access, request a copy of, and request an amendment to your record.
To request confidential communications at a specific address or phone number.
To know what your care is expected to cost and to receive a Good Faith Estimate if you are self-pay.
To free language assistance and auxiliary aids and services.
To have a family member, friend, or personal representative involved when you choose.
To formulate advance directives and have them respected as applicable.
To voice a complaint or grievance without fear of retaliation or loss of care.
To continuity of care and appropriate referral if we cannot meet your needs.

Your responsibilities

Provide accurate, complete information about your history, medications, and symptoms — in the office or by phone, not through this website.
Follow the treatment plan you agreed to, and tell us if it is not working.
Keep appointments, or give as much notice as possible when you cannot.
Ask questions when something is unclear.
Use one pharmacy for controlled medications and follow all prescribing agreements.
Treat staff and other patients with respect.
Keep your insurance and contact information current and meet your financial obligations.
Understand the consequences of declining a recommended treatment.

Raising a concern

Speak with your clinician first when you can. If that does not resolve it, contact our Privacy Officer, [PRIVACY OFFICER NAME — to be supplied by the practice], at (502) 454-8800 or in writing at 3430 Newburg Road, Suite 210, Louisville, KY 40218. You may also file a privacy complaint with HHS Office for Civil Rights — see our Notice of Privacy Practices — or a civil rights grievance as described in our Nondiscrimination notice. You may contact the Kentucky Board of Medical Licensure regarding a licensed physician.