Patient Rights and Responsibilities

West Beverly Podiatry Group, Inc.

Patient's Rights and Responsibilities

West Beverly Podiatry Group, Inc. promises to give you the best service possible and we want to give you the chance to talk openly about your care with us. If you have a concern or need help, please call us at (323)721-6026.

You Have the Right To

1. Receive care without discrimination because of race, religion, sexual orientation, ethnicity, national origin, age, mental/physical disability, or your ability to pay

2. Be treated with courtesy, consideration, dignity, and respect

3. Privacy in receiving your care and with all of your personal needs

4. Talk about all your health decisions with your doctor

5. Be given information that explanations that you can understand about your treatment

6. To know about the training of medical providers who care for you

7. Ask that your family be involved in your care with your consent

8. Receive information about West Beverly Podiatry Group, Inc. and the providers

9. Privacy in handling all of your personal, health, medical, and social information. West Beverly Podiatry Group, Inc. can not give this information to anyone unless you give your written permission, called

"written authorization"

10. Get medical necessary health services, including services to help you avoid disease, as well as treatment and education

11. Quickly receive a response to requests for services, including evaluations and referrals

12. Refuse any treatment recommended to you

13. Make any formal statement of complaint, called a "grievance," and/or dispute the care provided to you called an "appeal"; Complaints & Appeals can be sent to:

West Beverly Podiatry Group, Inc.

1417 W. Beverly Blvd., Ste. 104

Montebello, CA 90640

14. Be free from mental, physical, sexual, and verbal abuse

15. Get a second opinion from other doctors upon your request

16. Receive clear information in order to understand the forms you need to sign

17. Get emergency care if you feel you need it

18. Look at your health records and give your doctor a written comment if you feel something is missing or wrong

19. Receive information in a way that doesn't make you feel different because of your culture or language and to have it read aloud if you are blind or have trouble reading

20. Right to make suggestions about these Patient Rights and Responsibilities.

You Have the Responsibility to

1. Tell us about past illnesses and give correct information about hospital stays, medications, and other things about your health

2. Follow instructions about your care and let your provider know if you cannot follow them

3. Be Respectful West Beverly Podiatry Group, Inc. staff and property

4. Immediately let West Beverly Podiatry Group, Inc. know about changes in your address,

contact information, participation, and financial status.