You are responsible for:
- You are responsible for notifying the Center about any change in your address, telephone number, or any information you have given us.
- You should bring the name and address of other physicians you have recently seen and all medications you are taking, any copies of medical records you may have to assist us in your care.
You must provide:
- Your full name
- Proof of current address, such as rent receipt, voter's registration card, driver's license, utility bills, etc.
- Date of birth
- Proof
of income, i.e., pay stubs, unemployment compensation, social security
payments, welfare, etc., if you receive such assistance
- Immunization records for your children
- Medicare card
- Medicaid card
- Insurance information
Patient Rights
You have the right to have each of the following items clearly explained to you, by our staff:
- You have the right to treatment in this Center regardless of race, color, sex, or national origin.
- You have the right to be treated with consideration, respect and dignity.
- You
have the right to expect our staff members to display the highest
regard for your privacy while receiving services at this Center.
- You have the right to confidential treatment of your personal and medical records.
- You have the right to have your records released to the professional person of your choice for continuing care
- You
have the right to approve or disapprove the release of your records
except as required by law or third-party payment contract.
- You have the right to have the
procedures of this Center, the details of your treatment and medical
condition clearly explained by our professional staff and to ask
questions regarding your treatment or condition.
- You have the right to participate in the planning of your treatment and to consent to, of refuse any treatment.
- You
have the right to refuse to participate in experimental or research
projects or to be interviewed for research purposes. You have the right
to a full explanation of procedures used, and of the purposes and uses
of the information, if you do participate.
- You have the right to bring to the attention of the Center's staff, Executive Director or Medical Director any questions regarding the quality of treatment at this Center and the right to recommend changes for improving services.




