Patients Have the Right To:

• Not to be discriminated against based on race, national origin, religion, gender, sexual orientation, age, disability, marital status, or diagnosis;

• Receive treatment that supports and respects the patient’s individuality, choices, strengths, and abilities;

• Receive privacy in treatment and care for personal needs;

• Review, upon written request, the patient’s own medical record according to A.R.S. §§ 12-2293, 12-2294, and 12-2294.01;

• Receive a referral to another health care institution if this facility is not authorized or not able to provide physical health services or behavioral health services needed by the patient;

• Participate or have the patient’s representative participate in the development of, or decisions concerning treatment;

• Participate or refuse to participate in research or experimental treatment;

• Receive assistance from a family member, the patient’s representative, or other individual in understanding, protecting, or exercising the patient’s rights;

• Be treated with dignity, respect, and consideration;

• Not be subjected to abuse, neglect, exploitation, coercion, manipulation, sexual abuse, sexual assault or except as allowed in R910-1012(B), restraint or seclusion;

• Not be subjected to retaliation for submitting a complaint to the Department or another entity;

• Not be subjected to misappropriation of personal and private property by any clinic personnel member, employee, volunteer, or student;

• Consent to or refuse treatment, except in an emergency and to refuse or withdraw consent for treatment before treatment is initiated;

• Be informed of alternatives to medications or surgical procedure and associated risks and possible complications of medications or surgical procedure, except in an emergency;

• Be informed of the clinic’s policy on health care directives, and the patient complaint process;

• Consent to photographs before a patient is photographed, except that a patient may be photographed for identification and administrative purposes;

• Provide written consent to the release of information in the patient’s medical records or financial records, except as otherwise permitted by law.

Patients Have the Responsibility To:

• Be honest about matters that relate to you as a patient.

• Provide staff with accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters pertaining to your health.

• Report any perceived risks in your care.

• Report any unexpected changes in your condition to those responsible for your care and welfare.

• Follow the care, service, or treatment plan developed.

• Ask any questions when you do not understand or have concerns about your plan of care.

• Understand the consequences of the treatment alternatives and not following your plan of care.

• Know the staff who are caring for you.

• Be considerate and respectful of the rights of both fellow patients and staff.

• Honor the confidentiality and privacy of other patients.

• Be considerate of the property of Alevea Mental Health.

• Assure the financial obligations of your healthcare are fulfilled as promptly as possible.

How to File a Complaint

Patients or patient’s representatives that have any concerns about patient rights, safety, or complaints or grievances, please contact the Manager for the clinic or call 480-923-6200 and ask to speak with the Gaby Pano. Written correspondence will be forwarded to the healthcare provider and the medical director for the patient. Any patient or patient’s representative may submit a grievance without retaliation.

Patients also have the right to contact the Department of Health at any time at:

Arizona Department of Health Services
Attn: Licensing Medical Facilities
150 N. 18th Ave., Suite 450
Phoenix, Arizona 85007
(602) 364-3030
– or –
www.medicare.gov/ombudsman/resources.asp

 

Per A.R.S. § 36-436.01(C) – The Practice’s schedule of rates is available for review upon request. Per A.R.S. § 36-425(D), State inspection records are maintained in the Tempe office location of the 2034 E Southern AVE, Unit D. Tempe, AZ 85282. Requests may be made by calling 480-923-6200 and asking to speak with the Manager for Clinical Compliance.