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Patient Rights & Responsibilities

Patient Rights & Responsibilities - English 
Patient Rights & Responsibilities - Hmong 
Patient Rights & Responsibilities - Spanish

Patient Rights

Nondiscrimination & Access to Care

  • Care without discrimination based on age, color, race, ethnicity, ancestry, national origin, creed, religion, culture, language, physical or mental ability, disability, newborn status, source of payment, socioeconomic status, marital status, sex, including but not limited to sex assigned at birth, gender identity, recorded gender, or pregnancy or pregnancy-related
    condition, or sexual orientation.
  • The organization will recognize all state-sanctioned (permissible) marriage and spouses.
  • Appropriate medical screening and treatment regardless of payment or immigration status.
  • Free language assistance, including access to interpreters and auxiliary aids.

Respect & Safety

  • Safe environment free from abuse, neglect, harassment, restraint or seclusion unless medically necessary.
  • No required labor unless therapeutically appropriate and documented.

Privacy & Confidentiality

  • Privacy during treatment and private discussions about your care. If you would like an attendant present during any exams, please ask the staff.
  • Confidential handling of medical records and personal information.
  • Access to your medical records within a reasonable timeframe.

Participation in Care

  • Information about illness, treatments, risks and alternatives in understandable language and formats.
  • Right to refuse treatment with explanation of consequences.
  • Right to request to change providers if other qualified providers are available.
  • Preparation and honoring of advance directives. You will not be discriminated against, and your care will not be
    conditioned on the basis of whether or not you have completed an Advance Directive.
  • Inclusion of family or advocates in care decisions.
  • Pain management and involvement in discharge planning.

Visitation

  • Decide who may visit you, including spouses, partners, family and friends, and you may change your mind about this decision at any time.
  • Equal visitation privileges consistent with your preferences.
  • Restriction or limitations to visitation may be initiated when the organization has justified clinical reasons to do so.

Communication & Complaints

  • Prompt responses to questions and concerns.
  • Ability to file verbal or written complaints with clear resolution processes.
  • Contact information for Patient Experience department and state agencies.
     

Billing & Financial Assistance

  • Examine and receive explanations of bills.
  • Assistance with understanding costs and financial aid resources.

Patient Responsibilities 

  • Provide complete and accurate medical information.
  • Follow agreed treatment plans.
  • Keep appointments or notify if unable to attend.
  • Show respect for others by using polite language and behaving appropriately with staff and anyone around you. Treat the healthcare environment with care and respect other people’s property and belongings.
  • Accept financial responsibility for charges not covered by insurance.
  • Arrange responsible transportation home after procedures when advised.
  • Follow hospital rules and safety guidelines.
  • Share concerns promptly with care team or Patient Experience department.

Contact Information

Emplify Health by Bellin

State Agencies & External Review

If you have questions or need assistance, please contact your care team or patient services. Your health and satisfaction are our priorities.

744 South Webster Avenue
P.O. Box 23400
Green Bay, WI 54305-3400