Patient Rights and Responsibilities

As a patient of Advanced Family Surgery Center, you can expect to be treated individually and with the respect that you deserve. You have the right to:

• Receive treatment without discrimination on the basis of race, color, national origin, age, disability, or sex.
• Receive respectful and considerate care in a clean and safe environment.
• Understand your procedure, the process and implications.865-865-5001
• Receive all the information you need to make informed decisions about your care.
• Receive complete information about your diagnosis, planned treatment and prognosis.
• Participate in all decisions regarding your care.
• Receive private, confidential care of all information regarding your health and the records of your care.
• Approve or refuse the release of your medical records except when required by law.
• Know fees for service and the billing process.
• Refuse treatment and receive information on how your refusal can affect your health.
• Assure safe use of equipment by trained personnel.
• Change primary or specialty physicians if you so choose.
• Receive assessment of pain by trained personnel and have that pain treated efficiently.
• Ask your healthcare provider to wash their hands.
• Request the qualifications and credentials of healthcare professionals.
• Complain without fear of retribution about the care and service you receive. To file a formal complaint, you may contact the Division of Health Care Facilities.
• For more information about patient rights, and filing an appeal, visit the Centers for Medicare & Medicaid Services Website.
• Advanced Family Surgery Center cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.
• بقوانين الحقوق المدنية الفدرالية المعمول بها ولا يميز على أساس العرق أو اللون أو Advanced Family Surgery Center, يلتزم بالأصل الوطني أو السن أو الإعاقة أو الجنس.
• ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.
  Llame al 865-865-5001
• ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 865-865-5001 هاتف الصم والبكم.
• Advanced Family Surgery Center – Contact:
  Jill Winchester, RN, BS
  Administrative Director
  Phone: 865-865-5001

In turn, as a patient of Advanced Family Surgery Center it’s your responsibility to:

• Be respectful of all the healthcare providers and staff, as well as other patients.
• Provide accurate past and present medical histories, complaints, illness, hospitalizations, and surgeries.
• Accurately answer the pre-screening questionnaire and/or report any sudden changes in your health.
• Provide a list of current medications, including over-the-counter products, allergies, or sensitivities and dietary supplements.
• Inform the staff of your advance directives, POST, or power of attorney.
• Assure your financial obligations to the center for healthcare services rendered are
  paid efficiently.
• Accept responsibility for your outcome if you refuse treatment or procedure.
• Accept or understand the instructions given by the physician or staff. Follow the treatment plan prescribed by your provider.
• Keep your appointments or notify the center if you anticipate that your treatment will be delayed.
• Ensure the security of your own valuables.
• Provide a responsible adult to transport you home from the facility and have someone remain with you for 24 hours if required by your provider.

Download Patient Rights & Responsibilities PDF