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info@rachealhhc.com
1600 Sixth Avenue, suite 116B, York, PA, 17403
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Home
About Us
Services
Pediatrics
Companionship
Personal Care
Skilled Nursing
Careers
Resources
Forms
Contact Us
Blog
Schedule Consultation
Home
About Us
Services
Pediatrics
Companionship
Personal Care
Skilled Nursing
Careers
Resources
Forms
Contact Us
Blog
Schedule Consultation
Patient Rights and Responsibilities
The Patient has the Responsibility:
1. To provide, to the best of his/her knowledge, accurate and complete information about:
a. Past and present medical histories.
b. Unexpected changes in his/her condition.
c. Whether he/she understands a course of action selected.
2. To follow the treatment recommended, by the particular handling of the case.
3. For his/her actions, if he/she refused treatment, or does not follow the physician's orders.
4. To ensure that the financial obligations of his/her health care are fulfilled, as promptly as possible.
5. To respect the rights of all staff providing service.
6. To promptly notify the Agency, in advance, of an appointment or visit you must cancel.
7. To become independent in care to the extent possible, utilizing self, family, and other sources.
8. To pay for care, or services, not covered by 3% party payers.
9. To comply with the rules and regulations established by the agency and any changes subsequent to the rules.
Signature of Patient:
Date of Signature:
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Nurse/Therapist Signature:
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Patient Name:
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Medical Record #:
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