Northeast Wisconsin Foot and Ankle Associates
Patient Rights and Responsibilities
As a patient, you have the right to:
1. Become informed of rights as a patient in and attempts will be made to communicate in the language or manner primarily used by you. A list of these patient’s rights, which shall be posted within Northeast Wisconsin Foot & Ankle Associates and on their website so that such rights may be read by all patients.
2. Be treated with dignity and receive considerate and respectful care provided in a safe environment.
3. Remain free from all forms of abuse or harassment, seclusion or restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience or retaliation by staff.
4. Exercise these rights without regard to age, race, disability, sex or cultural, economic, education, or religious background or the source of the payment for care given.
5. Receive information from the physician about the illness, course of treatment and prospects for recovery in terms that the patient can understand.
6. Participate actively in decisions regarding medical care. To the extent permitted by law, this includes the right to request and/or refuse treatment.
7. Express concern regarding your care or any violation of your rights and that in doing so will not adversely affect the quality of care provided.
8. Change physicians if desired, either within Northeast Wisconsin Foot & Ankle Associates or another physician of the patient’s choice.
9. Confidential treatment of all communications and records pertaining to patient’s care and visit at Northeast Wisconsin Foot & Ankle Associates. The patient’s written permission shall be obtained before medical records can be made available to anyone not directly concerned with patient’s care.
11. Access information contained in your medical records within a reasonable time frame in accordance with state/federal laws and regulations.
12. Examine and receive an explanation of the bill regardless of source of payment. Information of payment policies and fees for service are available.
13. If eligible for Medicare, to know upon request and in advance of treatment whether a healthcare provider or facility accepts the Medicare assignment rate.
14. Expect reasonable safety insofar as Northeast Wisconsin Foot & Ankle Associates practice and environment are concerned.
15. Have all patient’s rights apply to the person who may have legal responsibility to make decisions regarding medical care on behalf of the patient.
16. Receive appropriate information regarding provider credentialing.
As a patient, you are responsible for:
1. Provide accurate and complete information about present complaints past illnesses, hospitalizations, any medications, including over-the-counter products and dietary supplements and any allergies or sensitivities, and other matters related to your health.
2. Ask questions when you do not understand your diagnosis or what is expected of you is not clearly understood.
3. Follow the treatment plan established by the physician, including the instructions of nurses and other health professionals as they carry out the physician’s orders.
4. Provide a responsible adult to transport the patient home from Northeast Wisconsin Foot & Ankle Associates and remain with the patient for 24 hours if required by the physician.
5. Keep appointment or notify Northeast Wisconsin Foot & Ankle Associates or physician when unable to keep an appointment.
6. Accept responsibility for any actions resulting from the refusal to follow treatment or physician’s orders.
7. Inform the physician about any living will, medial power of attorney or other directive that could affect the patient’ s care.
8. Accept and ensure that the financial obligations of care are fulfilled as promptly as possible.
9. Follow Northeast Wisconsin Foot & Ankle Associates policies and procedures.
10. Be considerate of the rights of other patients and Northeast Wisconsin Foot & Ankle Associates personnel.
11. Be respectful of personal property and that of other persons at Northeast Wisconsin Foot & Ankle Associates.
Northeast Wisconsin Foot & Ankle Associates strives to provide excellent patient care and service. If you should have a concern or complaint, please tell us so we can work to satisfy your needs. Ask to speak to the Office Manager.
You also have the right to contact the Wisconsin Division of Quality Assurance at 1-800-642-6552.