As a patient at The Secure Attachment Initiative, it is important that you are aware of your rights and responsibilities.

Rights

We are committed to observing and protecting your patient rights, including your right to:

• Equal service, regardless of race, gender, religion, ethnic background, education, social class, physical or mental disability, genetic information, sexual orientation, or economic status, including respect for your civil rights and religious opinions.

• Considerate, courteous, and respectful care from all SAI staff, including the right to know the names, titles, and professions of all staff with whom you speak and from whom you receive services or information.

• Complete information about your health and the care provided in terms you can understand.

• Reasonable continuity of care within the scope of services provided by SAI and its available staff.

• Informed consent, including a full discussion of risks, benefits, and alternatives prior to any invasive procedure, except in an emergency.

• Refusal of examination, discussion and procedures to the extent permitted by law, and to be informed of health and legal consequences of this refusal.

• Assistance in interpreting information for you/from you if you are not an English speaker or if you have other communication needs.

• Respect for your privacy and confidentiality of your personal health information/records as provided by law.

• Access to your personal health records.

• Examine and receive a full explanation of any charges for our services, regardless of the source of payment.

• Inform SAI management of your concerns and/or complaints without fear

of reprisal, by emailing our internal HR representative HR@secureattach.org

or verbally if the individual requires assistance at 719-645-2551.

• Inform your health insurance plan of your concerns and/or complaints without fear of reprisal by calling your health insurance plan’s customer service team at any time.

Responsibilities

We value your participation in helping us ensure the high quality and safe delivery of your care. Therefore, as our patient, please be aware of and consistently fulfill your responsibility to:

• Give your behavioral healthcare provider and other clinical staff correct and complete information about your health.

• Know all the medications you take.

• Tell your behavioral healthcare provider about any changes in your health.

• Ask questions to help ensure you understand what has been explained and what you need to do.

• Follow your treatment plan or tell your behavioral healthcare provider that you cannot follow it.

• Accept the results of either refusing treatment or not following the treatment plan.

• Read and understand or ask for assistance in understanding the information you receive about your health care benefits.

• Cancel any appointment you cannot keep with as much advance notice as possible, preferably with at least 24 hours advance notice.

• Meet your financial obligations to SAI.

• Respect the property of other people and SAI.

• Treat other patients, your healthcare provider, and all SAI staff with respect (the same way you expect to be treated).

For more information or any questions about HIPAA or your privacy,

contact us at HR@secureattach.org.