Promise Healthcare works with you to exceed your expectations. We respect your rights to healthcare access, equity, and safety; your privacy is our priority. Your rights, your responsibilities, and our pledges to you are listed below.

You have the right to:

• Receive respectful care regardless of your sex, age, race, religion, color, national origin, sexual orientation, or any other personal characteristics, including your primary source of payment.
• Be treated with consideration for your emotional, spiritual, and cultural needs.
• Be fully informed of available services at Promise Healthcare, including after-hours, emergency care, and fees for all services.
• Expect reasonable continuity of care and have a provider who manages your care.
• Request a second opinion when you believe it is necessary.
• Know the names and positions of people involved in your care by official name tag or personal introduction.
• Have a reasonable choice of providers and information about your options. Using our procedure, you can change providers if you are dissatisfied with your care. Please ask the front desk for help.
• Seek help, such as a wheelchair or interpreter, to obtain care easier.
• Receive the information about your health in a way that you can understand, take part in decisions about your care, and give your informed consent before any procedure is performed as per Illinois law.
• Be made aware of any unanticipated outcomes.
• Fully take part in the decision-making process about your care. You may have parents, guardians, family members, civil union partners, or other individuals you choose to be involved with.
• Refuse a recommended treatment to the extent allowed by law, and be informed of the risks and potential consequences of refusing to be treated.
• Expect that your health record will be kept confidential. For more information about your right to privacy, please review your HIPAA and Notice of Privacy statements.
• Ask and receive an explanation of any charges made by Promise Healthcare, even if they are covered by insurance.
• Complete an advance directive for end-of-life care. Please let your care team know if you are interested in learning more about advance directives.
• Express any complaints or concerns through our patient grievance/comments form.

As part of our contract with you, we pledge to:

• Provide you with ethical treatment by caring and qualified healthcare providers.
• Provide services that are available to you as you need them.
• Provide emergency coverage and provider availability on call, 24 hours a day, 7 days a week, by calling our office number. When the office is closed, the provider may phone you.
• Always deal with you honestly and openly.
• Provide you with financial help based on a sliding fee scale. This is dependent upon your income.
• Provide you with a confidential and detailed explanation of your bill of services.
• Participate in measures to always ensure patient safety.

You have a responsibility to:

• Arrive on time for scheduled appointments and tell us if you are going to be late. If you are late, we cannot guarantee your appointment. Call us at least 24 hours in advance if you need to cancel or reschedule.
• Provide us with at least 48 hours’ notice when you or a family member needs medications or a prescription.
• Follow all rules and regulations posted within Promise Healthcare.
• Speak and behave respectfully to Promise Healthcare staff and other patients.
• Respect the privacy and confidentiality of other patients.
• Turn off cell phones in clinical areas.
• Provide us with all the information you need so we can keep an accurate file for you. This includes reporting any changes to your address, telephone number, advance directives status, and financial status, if necessary.
• Pay your bills at the time of service, including co-payments and deductibles, or arrange a payment plan if needed.
• Provide honest and complete information about your health concerns, past health medical history, medications, and unexpected changes in your health so that we can provide you with the highest level of care.
• Provide us with medical records upon request.
• Ask questions if you do not understand any information or instructions we give you.
• Develop a treatment plan with your care team and follow it to the best of your ability. Be honest about what you have been able to do (or not do) when seen in follow-up. If you are unable to follow a treatment plan, we will do our best to help you find out why to change the plan or correct the problem if possible.
• Supervise children who are in your care.
• Please note: Making harassing, offensive, or intimidating statements or threats of violence could result in your removal from Promise Healthcare. If you are removed from one of our offices, you are considered removed from all Promise sites.