Please correct the errors described below.

You have the right to:

  • Competent, considerate and respectful health care, regardless of race, creed, age, sex or sexual orientation.
  • A personal clinician who will see you on an on-going basis.
  • An individualized treatment plan which considers you, your child’s and your family’s issues and needs.
  • A complete, easily understandable explanation of your condition, treatment, illness expectations as well as wellness needs.
  • Confidential management of communication and records pertaining to your medical care
  • The information necessary to make an informed decision about any treatment or procedure.
  • Coordination of care with referral physicians.
  • Same day urgent illness appointments when you call us early in the day
  • 24 hours, 7 days per week access to a Proyouth clinician for urgent issues.
  • To participate or not in any research project that might be presented for your consideration.
  • Any explanation of your medical bill.
  • The opportunity to file a complaint should a dispute arise regarding care, treatment or service.
  • The expectation that Proyouth will take reasonable steps to overcome cultural or other communication barriers that may exist between you and the staff.

You are responsible for:

  • Knowing your health care clinician’s name and contact information.
  • Giving your clinician correct and complete health history information, e.g. allergies, past and present illnesses, medications and hospitalizations, family and social history.
  • Providing staff with correct demographic and contact information, so we can readily reach you in the event of a schedule change and to give medical or clinical results. Providing staff with correct insurance information, initially, and when you have any changes.
  • Communicating to other caregivers not present during the office visit, all pertinent information discussed by the doctor.
  • Signing a “Release of Information” form when asked so your clinician can get medical records from other clinicians involved in your care and have outside clinician visits forwarded to us
  • Telling your clinician about all prescription medications, or other therapies, or over- the -counter medications you take.
  • Telling your clinician about any changes in your condition or reactions to medications or treatment.
  • Keeping your appointments, arriving on time and if you must cancel your appointment, please call the office at least 24 hours in advance.
  • Payment of copays, and any balances due at the time of service.
  • Prompt payment of any balance due for services rendered, after insurance submission.
  • Treating the Proyouth staff in a cordial and respectful manner.
  • Allowing for 3-day notification for prescription refills.
  • Allowing for 5-day notification for any form completion.
  • Requesting referrals and knowing/obtaining information from your insurance carrier as to network of providers, labs and radiology facilities for referral management.

Your information will be encrypted.