Patient Responsibilities. In order to protect the privacy of confidential information and to ensure that communications are properly routed, the Patient has the responsibility to: • Limit or avoid use of public computers and public networks; • Promptly inform INTEGRATE INTERNAL MEDICINE of changes in your email address or telephone number; • Ensure that any email or text is addressed to the intended recipient before sending; • List the key topic in the email subject line; • Put your name in the body of the email or text.
Patient Responsibilities. As conditions to membership, and without waiving any other obligation or condition listed elsewhere in this Agreement, Patient agrees to the following:
Patient Responsibilities. The patient will: Have the required blood monitoring tests as set out in these guidelines Not be eligible for treatment if monitoring blood tests are not carried out. Attend hospital and primary care appoints as required Consult GP/ Hospital clinician if any change in health status or any new concern with regard to medication or monitoring
Patient Responsibilities. (a) On the Effective Date, Patient shall pay NU House Calls an enrollment fee, in the amount of $1,000.00 (“Enrollment Fee”), which shall entitle Patient to receive the Services during the term of this Agreement, subject to the terms and conditions hereof.
Patient Responsibilities. 2.1. Patient will identify to SFM staff that they have an ABA on file with SFM when accessing products and services.
Patient Responsibilities. 4.1 The Patient agrees to: - Pay the membership fee on time. - Schedule appointments in advance and arrive on time for scheduled visits. - Notify the Clinic of any changes in contact information. - Adhere to the Clinic's policies and guidelines. pg. 1
Patient Responsibilities. 7.1 You agree (as well as paying the membership fees) to:
Patient Responsibilities. An effective therapeutic relationship is a collaborative experience between patient and therapist marked by openness, honesty, and a commitment to growth. In addition to your active participation in the therapeutic process, your compliance with the following policies is essential: Fee Policy The fee for therapy is $ per 50 minute session. Unless arranged otherwise, fees are to be paid by cash or check at the end of each session. Bank charges for NSF checks will be assumed by the patient. There are additional fees for extended telephone consultations, reports, and letters and these will be discussed by your therapist beforehand. Cancellations Please advise your therapist no less than 24 hours in advance if you are unable to keep an appointment, since sessions cannot be double-booked, and therapists must balance appointments with other patients. Failure to do so will result in the session fee being charged.
Patient Responsibilities. As a patient of Orthopaedic Xxxxxx Therapy Specialists, I understand it is my responsibility to provide accurate and complete information regarding medical needs, medical history, medications, demographics, and health insurance. It is my responsibility to report changes in my medical condition, medications, demographics, or insurance to the therapist and/or staff. It is my responsibility to request additional information about my medical condition or treatment when I do not fully understand the information or instructions given to me. I understand there is a medical records copying fee per page charged for obtaining copies of my medical records as allowed by Maryland law. This fee must be paid prior to picking them up. I understand that there is a charge for filling out disability and other miscellaneous forms. One page is $10.00; more than one page is $20.00. It is my responsibility to give at least 24 hours’ notice when I must cancel or postpone my appointment. I understand that my first missed or postponed appointment with Xxxx X. Xxxxxx D.P.T. not given within 24 hour notice will be waived, no questions asked. If the second appointment is missed or postponed we will charge $40.00 and the third or more will be charged at $80.00 per appointment. If more than three appointments are missed or postponed and charged for, we have the right to cancel all future appointments. If scheduled outside of normal business hours I will be charged $90 flat fee, no waived fee’s or acceptions with a missed or cancelled appointment not given within the time- frame. I also understand the therapists appointments are scheduled two months in advance in the beginning of each month. I also understand it is my responsibility to make sure my appointments are scheduled according to the physicians orders. Therapist’s Responsibilities Office hours are Monday-Friday 8:00am to 5:00pm. We are closed daily from 12:00pm to 1:00pm for lunch. Your therapist will see you in a timely fashion. If the therapist is running late, you will be given your full appointment allotment. Your therapist or will answer questions to the best of his or her ability. If you are unsure of any aspect of care, be sure to ask for clarification. Your therapist will strive to return calls within one (1) business day. Should you therapist decide to terminate services, you will be given the names of qualified therapists along with a copy of your medical records at your request. We appreciate the opportunity to assist ...
Patient Responsibilities. As a patient of the Psychological Services Training Center you agree to: Keep regular appointments and actively participate in your treatment. Attempt any therapeutic assignments you agree to perform. Make a commitment to living and using clinic and community resources to solve difficulties. You agree to disclose to your therapist whenever you feel in crisis and/or suicidal, to work with the therapist to come up with a crisis plan, and to give the clinic discretion regarding needed disclosures in a crisis situation. Not to come to the clinic under the influence of alcohol or other drugs. If you were to appear intoxicated, and at your therapist’s request, you agree to refrain from driving yourself. Failure to do so would result in a DUI report. Never bring a weapon of any sort to the clinic or on campus. Ask your therapist questions right away if you are uncertain about your evaluation, therapeutic process, or any clinic policy. Pay agreed upon evaluation and treatment fees or make arrangements to do so. ___________ Patient Initials
