Every patient deserves care that honors their dignity and safety.
As a patient at this facility, you have the right to:
- Seek and receive medical care free from discrimination.This facility prohibits discrimination based on race, color, national origin, religion, sex, sexual orientation, gender identity, age, disability or any other characteristic protected by applicable law. Care must not be denied, delayed or provided on less favorable terms for a discriminatory reason.
- Be treated with dignity and respect. You have the right to receive medical care free from abuse and harassment. This facility prohibits discriminatory slurs, threats and other harassing conduct by staff, providers, visitors and other patients. If you report such conduct, the facility will assess the concern and take appropriate steps to address it and protect your safety.
- Have your religious beliefs, practices and identity respected.You may wear religious clothing or items, observe religious practices and request accommodations, including dietary accommodations and access to spiritual support. The facility will consider these requests individually, consistent with applicable law and your clinical needs. If a request cannot be accommodated, staff will explain the reason and discuss available alternatives. Restrictions must not be imposed for a discriminatory reason.
- Request a different provider or medical care team.If you believe bias, discrimination or harassment has affected your care or safety, you may request a different provider or care team. The facility will review your request promptly and discuss available options.
- Raise concerns or file a complaint without retaliation.You may report suspected discrimination, harassment or other inappropriate conduct to staff, patient relations or the facility’s designated grievance contact. You may submit a grievance verbally or in writing. This facility prohibits intimidation, threats, coercion or other retaliation because you raise a concern, file a complaint or participate in an investigation. You may also contact an appropriate government agency without first completing the facility’s grievance process.
- Have grievances reviewed and receive a written response. The facility will review and investigate grievances through its established grievance process, which specifies time frames for review and response. When a grievance is resolved, you will receive a written response identifying the facility contact, the steps taken to investigate, the results of the grievance process and the date of completion.
- Designate visitors and request support from an advocate.You may designate visitors, including a family member, friend, clergy or advocate, and withdraw your consent to a visit at any time. Visitation restrictions must be applied without discrimination and consistently with applicable law. You may also request that a support person assist you in communicating with staff or raising a concern, subject to your consent and applicable privacy and safety requirements.
To report a concern or file a grievance:
Contact [Patient Relations / Grievance Office] at [phone number, email and location]. If you have an immediate safety concern, notify a staff member immediately.
This statement supplements the facility’s complete notice of patient rights. It does not limit any rights or remedies available under applicable law.