Patient's Rights and Responsibilities Statement /
Patient's Review and Agreement of Treatment Plan

Patient’s Rights and Responsibilities / Patient’s Review and Agreement of Treatment Plan
  • Patients have the right to be treated with dignity and respect.
  • Patients have the right to fair treatment. This is regardless of their race, religion, gender, ethnicity, age, disability, or source of payment.
  • Patients have the right to have their treatment and other member information kept private.
  • Only in an emergency, or if required by law, can records be released without patient permission.
  • Patients have the right to information from staff/providers in a language they can understand.
  • Patients have the right to an easily understood explanation of their condition and treatment.
  • Patients have the right to know all about their treatment choices, regardless of cost or if the costs are covered by their insurance company or not.
  • Patients have the right to information about Luzio & Associates Behavioral Services and their provider’s role in the treatment process.
  • Patients have the right to information about provider’s clinical qualifications.
  • Patients have the right to know the guidelines used in providing and/or managing their care.
  • Patients have the right to know about the complaint, grievance and appeal process.
  • Patients have the right to know that there may be State and Federal Laws that relate to their rights and responsibilities.
  • Patients have the right to know of their rights and responsibilities in the treatment process.
  • Patients have the right to share in the information of their plan of care.

    Statement of Patient’s Responsibilities
  • Patients have the responsibility to give providers needed information, so that the provider can deliver the best possible care.
  • Patients have the responsibility to let their providers know when the treatment plan no longer works for them.
  • Patients have the responsibility to follow their medication plan. They must tell their provider about medication changes.
  • Patients have the responsibility to treat those giving them care with dignity and respect.
  • Patients should not take actions that could harm the lives of Luzio & Associates employees, providers, or other patients.
  • Patients have the responsibility to keep their appointments. Patients should call Luzio & Associates Behavioral Services’ office as soon as possible if they need to change or cancel appointments. If appointments are cancelled with less than 24 hours’ notice or the patient does not show on three occasions then that client can no longer be seen by any providers at Luzio & Associates.
  • Patients have the responsibility to ask their providers questions about their care. This is so they can understand their care and their role in that care.
  • Patients have the responsibility to follow the plans and instructions for their care. The care is to be agreed upon by the patient and provider.
  • Patients have the responsibility to pay in a timely manner.
  • Patients have the responsibility to understand the scope and limitation of their insurance policies.
  • Patients have the responsibility to inform staff immediately of change in insurance coverage.
  • Patients have the responsibility, along with their providers, to not have conversations, therapy sessions, or send PHI through social media sites. Providers have the responsibility to not “friend” clients or accept friend requests from clients on personal social media because this blurs boundaries and comprises confidentiality.

    I have read and understand my Patient Rights and Responsibilities.
    I have reviewed, understand, and agree to my treatment plan.
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