Patient Bill of Rights and Responsibilities

To ensure the finest care possible, as a Patient receiving our Pharmacy services, you should understand your role, rights and responsibilities involved in your own plan of care.

Patient Rights

To select those who provide you with pharmacy services

To receive the appropriate or prescribed services in a professional manner without discrimination relative to your age, sex, race, religion, ethnic origin, sexual preference or physical or mental handicap

To be treated with friendliness, courtesy and respect by each and every individual representing our pharmacy, who provided treatment or services for you and be free from neglect or abuse, be it physical or mental

To assist in the development and preparation of your plan of care that is designed to satisfy, as best as possible, your current needs

To be provided with adequate information from which you can give your informed consent for commencement of services, the continuation of services, the transfer of services to another health care provider, or the termination of services

To express concerns, grievances, or recommend modifications to your pharmacy in regard to services or care, without fear of discrimination or reprisal

To request and receive complete and up-to-date information relative to your condition, treatment, alternative treatments, risk of treatment or care plans

To receive treatment and services within the scope of your plan of care, promptly and professionally, while being fully informed as to our pharmacy’s policies, procedures and charges

To request and receive data regarding treatment, services, or costs thereof, privately and with confidentially

To be given information as it relates to the uses and disclosure of your plan of care

To have your plan of care remain private and confidential, except as required and permitted by law

To receive instructions on handling drug recall

To confidentiality and privacy of all information contained in the client/patient record and of Protected Health Information; PHI will only be shared with the Patient Management Program in accordance with state and federal law

To receive information on how to access support from consumer advocates groups

To receive instructions on the safety disposal of drugs that are in compliance with state and federal laws and regulations

To know about philosophy and characteristics of the patient management program, if applicable

To have personal health information shared with the patient management program only in accordance with state and federal law, if applicable

The right to identify the program’s staff members, including of the program and their job title, and to speak with a supervisor of the staff member’s supervisor if requested

The right to speak to a health professional

To receive information about the patient management program

To receive administrative information regarding changes in or termination of the patient management program

To decline participation, revoke consent or dis-enroll at any point in time

Be fully informed in advance about care/service to be provided, including the disciplines that furnish care and the frequency of visits, as well as any modifications to the plan of care

Be informed, both orally and in writing, in advance of care being provided, of the charges, including payment for care/service expected from third parties and any charges for which the client/patient will be responsible

Receive information about the scope of services that the organization will provide and specific limitations on those services

Participate in the development and periodic revision of the plan of care

Refuse care or treatment after the consequences of refusing care or treatment are fully presented

Be informed of client/patient rights under state law to formulate an Advanced Directive, if applicable

Have one's property and person treated with respect, consideration, and recognition of client/patient dignity and individuality

Be able to identify visiting personnel members through proper identification

Be free from mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of client/patient property

Voice grievances/complaints regarding treatment or care, lack of respect of property or recommend changes in policy, personnel, or care/service without restraint, interference, coercion, discrimination, or reprisal

Have grievances/complaints regarding treatment or care that is (or fails to be) furnished, or lack of respect of property investigated

Confidentiality and privacy of all information contained in the client/patient record and of Protected Health Information

Be advised on agency's policies and procedures regarding the disclosure of clinical records

Choose a health care provider, including choosing an attending physician, if applicable

Receive appropriate care without discrimination in accordance with physician orders, if applicable

Be informed of any financial benefits when referred to an organization

Be fully informed of one's responsibilities

Patient Responsibilities

To provide accurate and complete information regarding your past and present medical history and contact information and any changes

To agree to a schedule of services and report any cancellation of scheduled appointments and/or treatments

To participate in the development and updating of a plan of care

To communicate whether you clearly comprehend the course of treatment and plan of care

To comply with the plan of care and clinical instructions

To accept responsibility for your actions, if refusing treatment or not complying with, the prescribed treatment and services

To respect the rights of Pharmacy personnel

To notify your Physician and the Pharmacy with any potential side effects and/or complications

To Notify Hope Specialty Pharmacy via telephone when medication supply is running low so refill maybe delivered to you promptly

To submit any forms that are necessary to participate in the program to the extent required by law

To give accurate clinical and contact information and to notify the patient management program of changes in this information

To notify their treating provider of their participation in the patient management program, if applicable

To maintain any equipment provided

If you have questions, concerns or issues that require assistance, please call 1-800-557-5555.  Complaints will be forwarded to management and you will receive a response within 5 business days.