Patient Rights and Responsibilities
The goal of FEMMEmpowerment and Advocacy, LLC concierge physical therapy is to provide all patients with high quality health care in a manner that clearly recognizes individuals needs and rights. We also recognize that to accomplish this goal effectively, the patient and the health care provider must work together to develop and maintain optimum health. As a result, the following patient rights and responsibilities were written:

As a patient you have the right:
To receive considerate care that is respectful of your personal beliefs and cultural and spiritual values.
To have all things explained to you in terms that you can understand and to have any questions answered concerning your diagnosis, prognosis, and treatment.
To appropriate assessment and management of your symptoms, including pain.
To know what the diagnosis is; what the prognosis is; what treatment will be used; how risky treatment is; whether it will hurt and for how long.
To know the contents of your medical records through interpretation by the provider.
To know who it is that is interviewing and examining you.
To have explained to you ways that you can prevent your medical problem from recurring.
To refuse to be examined or treated by health practitioners and to be informed of the consequence of such decisions.
To be assured of the confidential treatment of disclosures and records and to have the opportunity to approve or refuse the release of such information except when release of specific information is required by law or is necessary to safeguard you or the university community.
To participate in the consideration of ethical issues that may arise in provision of your care.

As a patient you have the responsibility:
To provide FEMMEmpowerment and Advocacy with information about past illnesses, hospitalizations, and medications.
To provide FEMMEmpowerment and Advocacy with any contagious illness or bacteria you may have in order to allow the clinician to protect herself.
To provide clinician accurate information about past trauma, pregnancies, etc. that may affect your treatment.
To ask questions if you do not understand the directions or treatment being given by the provider.
To keep appointments or telephone within 24 hours ahead of time to cancel.
To be resepctful of clinician and FEMMEmpowerment and Advocacy property.

Privacy Notice:
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review carefully:
FEMMEmpowerment and Advocacy respects every patient's right to privacy. We will not release personally identifiable information about you without your permission, unless, the release is in accordance with federal and state laws.
The clinician of FEMMEmpowerment and Advocacy is required to safeguard your privacy in all settings. We have procedural and physical safeguards in place to protect your information. As a user of FEMMEmpowerment and Advocacy you give us your consent to use the information internally to provide the best care for you and to disclose information outside of FEMMEmpowerment and Advocacy in accordance to state and federal laws as follows:
To you, upon your request
To a provider, such as your physician/hospital/others who provide medical care and service to you
To a government or regulatory body, such as law enforcement agency (e.g. investigation of a crime), or a court (e.g. in response to a subpoena), or to a public health facility (e.g. to report an infectius disease)
For marketing purposes via social media.

Although your health record is the physical property of FEMMEmpowerment and Advocacy, the information belongs to you.

You have the right to:
Request a restriction on certain uses and disclosures of your information.
Obtain a copy of this notice of confidentiality practices on requirements.
Inspect and obtain a copy of your health record as per our policy.
Amend your health record as per our policy.
Obtain an accounting of disclosures of your health information.
Request communication of your health information by alternative means or at alternative locations.
Revoke your authorization to use of disclosed health information except to the extent that the action has already been taken.
Say no to any treatment offered.

As the provider of your health care we have the responsibility to:
Maintain the privacy of your health information.
Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
Abide by the terms of this notices.
Notify you if we were unable to agree to a requested restriction.
Accommodate reasonable requests you may have to communicate health information by alternative means or alternative locations.
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. If our information practices changes, we will notify you in writing. We will not use or disclose your health information without your authorization, except as described in this notice.

By Checking Below, You agree to the above rights and responsibilities. *
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