THE PATIENT HAS THE FOLLOWING RESPONSIBILITIES:
• To provide the Office with accurate medical information.
• To ask all questions you may have regarding the treatment provided by the center.
• To consent by free will to all medical procedures.
• To tell us if you do not understand medical procedures or instructions.
• To follow aftercare instructions as recommended by the center.
• To contact Parkmed NYC with post-procedure questions or concerns.
• To pay all fees in the required manner prior to services rendered and accept personal financial responsibility for charges not covered by insurance.
• To observe the center’s policies and regulations, including those pertaining to conduct.
• To keep appointments as scheduled, or advise the Office if unable to keep appointment.
• To inform Parkmed NYC if you have a Living Will, Medical Power of Attorney, or any other Healthcare directive.
• To bring an escort to accompany him/her and remain for 24 Hours if required by Parkmed NYC. THE PATIENT HAS THE RIGHT TO:
• Understand and use these rights. If for any reason you do not understand or you need help, the facility must provide assistance, including an interpreter.
• Receive services without regard to age, race, color, sexual orientation, religion, marital status, sexual orientation, national origin, disability or source of payment.
• Be treated with consideration, respect and dignity including privacy in treatment.
• Be informed of the services available at the Office in a clean, safe environment free of unnecessary
• Receive emergency care if you need it.
• Be informed of the provisions for off-hour emergency coverage.
• Be informed of the name and position of the doctor who will be in charge of your care in the facility.
• Know the name, positions and functions of any facility staff involved in your care and refuse their treatment,
examination or observation.
• Receive all the information that you need to give informed consent for any proposed procedure or
treatment. This information shall include the possible risks and benefits of the procedure or treatment.
• Be informed of the charges for services, eligibility for third-party reimbursements and, when applicable, the availability of free/reduced cost care.
• Receive an itemized copy of your account statement, upon request.
• Obtain from your health care practitioner, or the health care practitioner’s delegate, complete and current information concerning your diagnosis, treatment, and prognosis in terms the patient can be reasonably expected to understand which allows for participation in treatment when indicated.
• Refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of your action. You may select another provider if one is available.
• Refuse to participate in experimental research with a full explanation.
• Voice grievances and recommend changes in policies and services to the Office’s staff,
the operator and the New York State Department of Health without fear of reprisal.
• Contact the New York State Department of Health to voice concerns at 800-804-5447 433 River Street, 6th Floor Troy, NY 12180 or Medicare Ombudsman @ www.medicare.gov.
• Express complaints about the care and services provided and to have the center investigate such complaints.
• Privacy while in the facility and confidentiality of all information and records regarding your care.
• Approve or refuse the release or disclosure of the contents of your medical record to any health care practitioner and/or health care facility except as required by law or third-party payment contract.
• Access your medical record pursuant to the provisions of the law.
• Receive information about advance directives.
• Delegate an individual to give consent for an order not to resuscitate if you are too ill to do so.
• Receive information about the credentialing of our healthcare providers.
800 Second Ave, 6th Floor, New York, NY 10017
212-686-6066 | 800-346-5111