Patient Rights and Responsibilities

Welcome to CommUnityCare

Our goal is to provide quality health care in our community. As a patient, you have rights and responsibilities. CommUnityCare also has rights and responsibilities. We want you to understand these rights and responsibilities so you can help us provide better health care to you. Please read the Consent for Treatment form, ask us questions you might have and sign at the bottom of the form.

Human Rights

You have a right to be treated with respect and dignity regardless of your race, religion, sex, national origin, sexual orientation, political affiliation, disability or ability to pay for services.

Payment for Services

  • You are responsible for giving us accurate information about your present financial status and any changes in your financial status. CommUnityCare needs this information to decide how much you pay or private insurance, Medicaid, or Medicare pays. This information may also be used to find other benefits for which you are eligible.
  • You have a right to receive explanations of your bill. You must pay, or arrange to pay, all agreed fees for medical services or dental services, as provided by our policies. If you cannot pay right away, please let us know so CommUnityCare can provide care for you now and work out a payment plan.


You have a right to have your health examination, and treatment in private. Your medical records are also private. Only legally authorized persons may see your records, unless you request in writing for us to show them to someone else. A complete discussion of your privacy rights is included in the Notice of Privacy Practices. The notice details the various rights granted to you under the Health Insurance Portability and Accountability Act (HIPAA).

Health Care

  • You are responsible for providing CommUnityCare complete and current information about your health or illness, so we can provide you proper health care. You have a right to, and are encouraged to participate in decisions about your treatment.
  • You have the right to information and explanations in the language you normally speak and in words you understand. You have a right to information about your health or illness, treatment plan (including benefits and risks), and expected outcomes, if known, and information regarding Advance Directives.
  • If you are an adult, you have a right to refuse treatment to the extent permitted by law, and to be informed of the risks of refusing such care. You are responsible for the outcome of refusing treatment.
  • You have the right to health care and treatment that is reasonable for your condition and within our capability.
  • If you are in pain, you have a right to receive an appropriate assessment and management, as necessary.


  • You are responsible for using CommUnityCare services in an appropriate manner. If you have questions about using these services, please ask us.
  • You have a responsibility to keep your scheduled appointment and to arrive on time. Missed scheduled appointments cause delay in treating you and other patients. If you do not keep scheduled appointments, you will be asked to meet with a staff member to discuss the reason for your missed appointments and whether you may continue as a patient of CommUnityCare.
  • You have a responsibility to be courteous and respectful to CommUnityCare staff and other patients.
  • You are responsible for the supervision of children you bring with you to CommUnityCare. You are responsible for their safety and the protection of other clients and our property.


If you are not satisfied with our services, please tell us. CommUnityCare want suggestions so we can improve our services. CommUnityCare staff will tell you how to file a complaint. CommUnityCare will not punish you for filing a complaint and will continue to see you as a patient.


CommUnityCare can decide to stop treating you as a patient. If CommUnityCare decides to stop treating you as a patient, you will be notified of the decision. You will be given 30 days to find another health care provider. During those 30 days, CommUnityCare will only provide care to you for immediate, serious health conditions. CommUnityCare can also decide to stop treating you immediately and without notice if CommUnityCare has determined that you have created a threat to the safety of the staff or other patients. You also have a right to receive a copy of the CommUnityCare termination policy

Reasons for which CommUnityCare may stop providing health care services to you:

  1. Failure to follow CommUnityCare rules and requirements.
  2. Failure to keep scheduled appointments.
  3. Intentional failure to report accurate information concerning your health.
  4. Intentional failure to follow the health care program, such as instructions about taking medications personal health practices, or follow-up appointments, as recommended by your doctor.
  5. Creating a threat to the safety of the staff and/or other clients.
  6. Intentional failure to accurately report your financial status.