To request and obtain the name and specialty of the physician or other person responsible for your care or coordination of care;

2.

to refuse to be examined, observed or treated by students or any other staff member without jeopardizing access to medical care and attention;

3.

to informed consent to the extent provided by law;

4.

to have your Advance Care Directives honored;

5.

to interpreter services at no cost to you;

6.

to have your reports of pain believed;

7.

to receive information about pain relief measures;

8.

to have your pain assessed and managed by staff who are committed to pain management and will respond in a timely manner to your report of pain;

9.

to confidentiality of all records and communications to the extent provided by law;

10.

to privacy during medical treatment or care within the capacity of Faulkner Hospital;

11.

to prompt life-saving treatment in an emergency without discrimination because of source of payment or economic status or delay due to discussions of source of payment unless such delay will not pose a material risk to your health;

12.

to refuse to serve as a research subject and to refuse any care or examination when the primary purpose is educational or informational rather than therapeutic;

13.

to obtain a copy of any rules or regulations of this hospital which apply to your conduct as a patient;

14.

to have all reasonable requests responded to promptly and adequately within the capabilities of the hospital;

15.

to prompt and safe transfer to a facility that agrees to provide treatment, if refused treatment for economic status or lack of a source of payment;

16.

to complete information on all alternative treatments that are medically viable, if suffering from breast cancer;

17.

to request and obtain an explanation as to the relationship of Faulkner Hospital to any other healthcare facility or educational institution in so far as it relates to your treatment or care;

18.

to request and receive information which the facility has available relative to financial assistance and free care;

19.

to request and to inspect your medical records and to receive a copy for a fee determined by the current rate of copying expenses;

20.

to request and receive a copy of your medical record free of charge if you show that your request is to support a claim or appeal under any provision of the Social Security Act in any state or federal financial needs-based benefit program;

21.

to request and receive an itemized bill reflecting laboratory charges, pharmaceutical charges, radiology charges, third party credits and to examine the bill. This shall be available to the attending physician as well.

To let us know your expectations about hospitalization and treatment;

2.

to supply us with all appropriate information about past hospitalizations, medications, perceived risks in your care and other matters relating to your health;

3.

to tell us about all medications and supplements you are taking, including alternative medicines and illegal or addictive drugs;

4.

to tell us about any situation at home or work that may affect your ability to care for yourself, so that we can direct you to resources that can help;

5.

to understand your healthcare. If you are unclear about either your condition or treatment, ask your physician or other members of the healthcare team;

6.

to report your pain to us to the best of your ability;

7.

to identify your pain management goal;

8.

if you refuse treatment, to accept full responsibility for your decision and the consequences to your care;

9.

to follow hospital rules and regulations;

10.

to respect the privacy of other patients;

11.

to express your concerns to your caregivers in a respectful manner;

12.

to consider appointing a health care proxy and completing advance care directives, so that we know what kind of care you wish to have should you become unable to tell us;

13.

to take reasonable care of your own valuables and other possessions and send valuables home for safe keeping;

14.

to pay your hospital bill promptly and to supply us with necessary health insurance information.