The Little Clinic is committed to providing and protecting all our Patients Rights as outlined in the following Patient Bill of Rights and Responsibilities.

To print a copy of this document click here.

PATIENT BILL OF RIGHTS AND RESPONSIBILITIES

AT THIS CLINIC, THE PATIENT HAS THE FOLLOWING RIGHTS:

• To choose the provider of your healthcare services;
• To be treated with courtesy, respect, and appreciation of individual dignity, and in a manner that protects privacy and confidentiality of personal information;
• To receive care in a safe environment free from neglect, exploitation, or physical or mental abuse;
• To impartial access to healthcare treatment or accommodations regardless of race, national origin, religion, age, sex, disability, or source of payment;
• To receive information regarding treatment in an understandable manner, and to participate in decisions regarding your care;
• To prompt, reasonable response to questions and requests;
• To know who is providing your healthcare services and who is involved with your care;
• To have a personal representative with you during the receipt of your care;
• To know the patient support services available, including qualified interpreter services if you do not speak English;
• To refuse any treatment, except as otherwise provided by law. However, due to the nature of the clinic’s scope of services, we are NOT able to honor patient Advance Directives limiting life-saving efforts. Accordingly, pursuant to clinic practitioner’s professional judgment and discretion, rescue attempts may be made and 911 will be called if there is an emergency involving a patient;
• To receive, upon request, a reasonable estimate of charges for your healthcare;
• To access your designated medical record set within a reasonable time of your request as provided by law;
• To know, upon request and in advance of treatment, if you are eligible for Medicare whether the healthcare provider or facility accepts the Medicare assignment rate;
• To receive a copy of your bill and, upon request, to have the charges explained;
• To know if medical treatment is for the purpose of experimental research and to give your consent or refusal to participate in such experimental research; and
• To express grievances, without retaliation, regarding any violation of these rights or concerns related to your healthcare to The Kroger Co., by calling 1-888-852-2567, and to the appropriate state licensing agency, state department of health, Joint Commission, and/or federal agency.

THE PATIENT HAS THE FOLLOWING RESPONSIBILITIES:

• To provide the healthcare provider, to the best of your knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters related to your health;
• To report to the healthcare provider unexpected changes in your condition;
• To report to the healthcare provider whether you comprehend a contemplated course of action/treatment and if you have any questions;
• To follow the treatment plan recommended by the healthcare provider;
• To keep appointments, as applicable, and when unable to do so for any reason, to notify the healthcare provider;
• To acknowledge you are responsible for your actions, including if you refuse treatment or do not follow the healthcare provider's instructions;
• To fulfill the financial obligations related to your healthcare and treatment; and
• To follow the clinic’s rules and regulations affecting patient care and conduct.