The following list of patient rights is not intended to be all inclusive.
Every patient has the right to:
- Be treated with dignity and respect
- Be free from all forms of abuse or harassment
- Privacy and confidentiality concerning their medical care - the patient has the right to be advised as to the reason for the presence of any individual directly involved or observing their care
- Have their questions, concerns or complaints addressed in good faith
- Be provided with complete and understandable information about their evaluation, diagnosis, indications for tests and procedures, treatment and alternatives, prognosis, and both normal and abnormal test results. Such communication will be in a timely manner.
- Make choices and decisions regarding their medical care to the extent permitted by law - this includes the right to refuse treatment
- Transfer to another health care provider, if other qualified providers are available.
Receive, on request, information about services available, fees and charges, payment
policies, and receive an explanation of their bill, regardless of source of payment
- Receive, on request, and at a reasonable fee established by the Health Information Management Department, a copy of their medical record
- Have an advance directive concerning treatment or designation of a surrogate decision maker
Voice grievances about care that was received, or not received
Exercise these rights without regard to gender, cultural, economic, educational or religious background
- Request a chaperone be present upon request
- Be free of discrimination or reprisal if exercising their rights
The care a patient receives depends partially on the patient. Therefore, in addition to these rights, a patient has certain responsibilities as well. These responsibilities shall be presented to the patient in the spirit of mutual trust and respect.
The patient has the responsibility to:
Provide accurate and correct information, including full name, address, home telephone or
cell phone number, date of birth and photo ID, when it is requested
Provide correct and complete information concerning their current concerns, past medical
history, and other matters relating to their health
- Make it known whether they clearly comprehend the course of their medical treatment and what is expected of them
Be an active participant in identifying and following an agreed-upon treatment plan,
noting that lack of understanding can be expressed at any time
Accept responsibility for their actions should they refuse treatment or not follow their
- Keep appointments and notify Marshfield Clinic when unable to do so
- Follow our facilities policies and procedures
Provide complete and accurate information about their health insurance coverage; provide
their insurance card and employer upon request
- Know their health insurance benefits before receiving treatment and confirm coverage if unsure
- Assure that financial obligations of their care are fulfilled as promptly as possible
- Be considerate of the rights and property of other patients and facility personnel
If you have any comments or concerns regarding services provided at Marshfield Clinic, please contact our Nurse Liaison at 1-800-782-8581, ext. 7-5300, or write Nurse Liaison, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, WI 54449-5777.
If our nurse liaisons are not able to resolve a concern to your satisfaction, to file a complaint, visit
www.medicare.gov or call 1-800-MEDICARE (1.800.633.4227). TTY users call 1-877-486-2048.
-- Or contact --
Wisconsin Dept of Health Services at
http://dhfs.wisconsin.gov/bqaconsumer/HealthCareComplaints.htm or call toll free: 1.800.642.6552 or write: Division of Quality Assurance P.O. Box 2969, Madison, WI 53701-2969.
Este documento sobre los derechos del paciente
esta disponible en Español. por favor pregunte en informacion al paciente. (Patient Rights and Responsibilities in Spanish)
Daim ntawv hais txog tus neeg mob txog cai muaj
sau ua ntawv Hmoob. Nug thawm lub rooj ua hauj lwm ntawm ko. (Patient Rights and Responsibilities in Hmong)