Patient Information

• To be treated with respect, dignity, and consideration of the individual patients values and beliefs.
• To be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation while under the care of Health Services.
• To receive the best care available for your problem, without regard to national origin, race, age, gender, religious beliefs, sexual orientation,  disability, or illness.

• To know the identity and professional status of individuals providing your care.
• To understand your diagnosis, condition and treatment and make informed decisions about your care after being advised of material risks, benefits and alternatives.
• To be informed about the outcomes of your health care, including unanticipated outcomes.
• To have your pain assessed, treated and managed appropriately.
• To participate in decisions involving your health care and in resolving conflicts about care decisions.
• To refuse care, treatment, or services in accordance with law and regulation and to be informed of the medical consequences of such action.
• To refuse participation in research studies.
• To request a referral to another health care provider for a second opinion concerning your health issues.

• To confidential treatment of disclosures and records, and to approve or refuse the release of such information, except where release is required by law.
• To a safe and accessible environment.
• To have your bill explained and receive information about charges that you may be responsible for.

Notice of Privacy
Notice of Privacy - Spanish Translation

• Advance Health Care Directives:

Legal documents in which you can give written instructions about your health care if, in the future, you cannot make decisions or speak for yourself.  Learn more about Advance Health Care Directives and to obtain and complete the forms.

• Advanced Health Care Directives
• Got Plans?
• Advance Directive Planning Guide
• An Advance Directive For North Carolina; A Practical Form for All Adults

If you decide to complete the forms, please bring a copy to Health Services in the Bird Building so it can be placed in your records.

• HealthCare or Medical Power of Attorney (POA)

A Power of Attorney (POA) is a person that has been designated to make medical, financial or legal decisions on your behalf when you are unable to make decisions for yourself.

• If you have legally designated an individual POA or Medical POA, this documentation should be kept with you and with the designated POA.
• Health Services can scan a Medical POA into a your electronic health record for reference, but be aware that if you are seen at a local hospital or different health care facility, this information would need to be provided directly to that facility by yourself or your designated POA. Consult an attorney to discuss your needs and state requirements.
• Having a designated POA does not automatically allow Health Services to release medical bills and patient records to that person in most situations with your signed release of information of protected health information, unless you were unable to authorize that release.

• To voice concerns and/or recommend changes in policies and services.
• To request a referral to another health care provider for a second opinion concerning your health issues.

Reporting a Complaint or Grievance
All grievances will be reported to the Director of Health Services. This may be done in person, by telephone or by email. Once received, the director will fill out the incident report form and respond to the patient within 24 hours. If satisfaction is not received, the director will refer the grievance to the Office of Student Affairs for review.

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• The right to information regarding any charges that are not covered by the student health fee
• The right to examine your billing records
• You have the right to request a list of the disclosures we have made of your information.

• Obtain a copy - You have the right to request to see and obtain a copy of the medical information that may be used to make decisions about your care as maintained in our designated record set.
• Request an amendment - If you feel that your medical information is incorrect, you have the right to request an amendment
• Restrictions and confidential communications - You have the right to restrict disclosure of your information to your health plan (insurance) for services that you pay in full out of pocket.

• It is your responsibility to provide full information about your illness or problem to allow proper evaluation and treatment.
• You are responsible for communicating with your healthcare provider if your condition worsens or does not follow the expected course.
• If you provider recommends testing or a referral to a specialist, discuss what that means for you, and the consequences if you decline testing or additional treatment.

• Acknowledge the treatment plan recommended by your health care professional and to express concerns regarding your ability to comply. 
• Understand the consequences of actions should treatment, care or services be refused or if the choice is made not to comply with the health care professional’s instructions.
• You are responsible for arrangements for continued care after you leave the university. Work with your provider to explore possible avenues for continued treatment.
• Be aware of when and where to get further treatment, as well as what you need to do at home to assist in your recovery.
• If your continuity of care is disrupted, it is your responsibility to seek additional resources by contacting your primary healthcare provider.

• It is your responsibility to be informed. Ask your health care provider sufficient questions to ensure appropriate comprehension of your illness or problem. If you find the care or course of treatment unacceptable for any reason, please discuss this with a member of the staff. If you are dissatisfied, we request that you discuss your concerns with the Director of Health Services.

• It is your responsibility to use identified methods of expressing grievances and suggestions, whenever indicated, in order to assist the clinic in improving quality of its services.
• Bring forward suggestions or concerns on care and safety about campus health programs or staff. Engage in open communication and assurance of continued access to care. 

• It is your responsibility be courteous and respective to all staff and health care personnel.
• Arrive early in order to secure parking and get checked-in before your actual appointment time.
• Be kind to other patients and visitors at Health Services.
• You are responsible for keeping all appointments. If you are unable to keep an appointment, please cancel or reschedule within 24 hours.

• Ask the appropriate staff at Health Services about the cost of services.
• Provide up to date insurance information to assist with filing insurance claims.
• Make arrangements to pay the amounts you owe for services and care.