Client Rights and Responsibilities
- I have the right to receive information about my managed care companies’ services and treatment providers, clinical guidelines, and client’s rights and responsibilities.
- I have the right to be treated with respect and dignity.
- I have the right to privacy and confidentiality.
- I have the right to fair treatment. This is regardless of race, religion, gender, ethnicity, age, disability, or source of payment.
- I have the right to the rights and privileges granted by State and Federal Law.
- I have the right to participate with my treatment provider in decision-making regarding treatment planning.
- I have the right to voice a complaint or appeal should a dispute arise over treatment or claims.
- I have the right to make recommendations regarding client rights and responsibilities policies that may be implemented.
- I have the right to a candid discussion of appropriate or medically necessary treatment options for my condition(s), regardless of cost or benefit coverage.
- I have the responsibility to provide, to the extent possible, information that my provider(s) need in order to care for me.
- I have the responsibility to follow the plans and instructions for care that I have agreed upon with my treatment provider.
- I have the responsibility to participate, to the degree possible, in understanding my behavioral health problem(s) and developing mutually agreed-upon treatment goals.
- I have the responsibility to inform my provider of changes in my address and insurance coverage.
- I have the responsibility to keep scheduled appointments and comply with my treatment provider’s cancellation policy.
* I have read or had this read to me. I understand what it means and agree to participate in the treatment.