Phone 303-781-0511 | Fax 303-781-0517 | 323 W Drake Rd Suite 200 Fort Collins Colorado 80526

Patient Rights & Responsibilities

Patient Rights and Responsibilities

As a patient you have the right to the following

Personal Privacy

To have your personal dignity respected. To the confidentiality of your identifiable health information. To have personal privacy in a safe, clean environment. To have supportive person(s) attend your appointments of your choosing (where appropriate), including a spouse, a domestic partner (including a same-sex domestic partner), or another family member or a friend.


To be free from all forms of abuse or harassment.

Cultural and Spiritual Values

To have your cultural, psychosocial, spiritual, and personal values, beliefs and preferences respected.

Access to Care

To receive care regardless of your age, race, color, national origin, culture, ethnicity, language, socioeconomic status, religion, physical or mental disability, gender, sexual orientation, gender identity or expression, or manner of payment. To ask for a change of provider or a second opinion without judgment or interruption in your care.

Access to Information

To make advance directives and have them followed. To have your family or a representative you choose and your own physician be informed of your care. To know the rules regulating your care and conduct. To know the names and professional titles of your caregivers. To have your bill explained and receive information about charges that you may be responsible for, and any potential limitations your policy may place on your coverage. To be told what you need to know about your health condition after the office visit. To be informed and involved in decisions that affect your care, health status, services or treatment. To understand your diagnosis, condition and treatment and make informed decisions about your care after being advised of material risks, benefits and alternatives. To knowledgeably refuse any care, treatment and services. To legally appoint someone else to make decisions for you if you should become unable to do so, and have that person approve or refuse care, treatment and services. To have your family or representative involved in care, treatment and service decisions, as allowed by law. To be informed of unanticipated adverse outcomes.


To receive information you can understand. To allow access to an interpreter and/or translation services during your appointment. To know the reasons for any proposed change in the physicians/professional staff responsible for your care.


To request a listing of disclosures about your healthcare, and to be able to access and request to amend your medical record as allowed by law. To know the relationship(s) of the clinic to other entities participating in the provision of your care.

Recording and Filming

To provide prior consent before the making of recordings, films or other images that may be used externally.

 Concerns, Complaints or Grievances

To receive a reasonably prompt response to your request for services. To be involved in resolving issues involving your own care, treatment and services. To express concerns, complaints and/or a grievance to your providing clinic personnel.

As a patient, it is your responsibility:

Provision of Pertinent Information

To give us complete and accurate information about your health, including your previous medical history and all the medications you are taking. To inform us of changes in your condition or symptoms, importantly pain, falls, confusion, or hallucinations or concerning depression.

Ask Questions, Follow Instructions, Schedule Medical Follow-up Visits

To let us know if you don’t understand the information we give you about your condition or treatment. To speak up. Communicate your concerns to any staff member as soon as possible. To inform the medical team if you cannot follow treatment directions or are experiencing a side effect. Your care and treatment outcomes depend on appropriate follow-up with your medical team. Maintaining a therapeutic relationship requires your participation in attending scheduled medical follow-up visits.

Refusing Treatment and Accepting Consequences

To follow our instructions and advice, understanding that you must accept the consequences if you refuse.

Explanation of Financial Charges

To pay your bills or make arrangements to meet the financial obligations arising from your care.

Following Rules and Regulations

To follow our policies and regulations. To keep your scheduled appointments, or let us know 24 hours in advance if you are unable to keep them. To inform the staff is more than 2 individuals will be attending your appointment.

Respect and Consideration

To be considerate and cooperative to your medical team. To respect the rights and property of others. To respect other individuals in the clinic. To understand other patients in our clinic may be experiencing distress or feeling unwell.

Breach in the Therapeutic Relationship

When your medical team can no longer provide a therapeutic relationship, you will be referred to another medical provider of the same specialty. This referral will be coordinated so to avoid a lapse in medical care for your condition. Examples of a breach in therapeutic relationship includes: acting in a threatening manner to the medical team or staff, giving deliberate false information to the medical team or staff, posing a threat to the health of the clinic or the patients that are under the care of the medical team.