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Please bring the following with you to Tri City Surgery Center: - page 13 / 15





13 / 15

Your Responsibilities

So that you may contribute effectively to your health care, you have, as a patient, the following responsibilities:

  • 1.

    To provide the center with a copy of any advance directives, Living Will, or Healthcare Power of Attorney you may have executed.

  • 2.

    To be honest and as accurate as possible when asked for information about your medical history and everything that happens to you as a patient, including present and past illnesses, hospitalizations, medications, allergies, and “NPO” status.

  • 3.

    To make every attempt to understand the implications of my procedures, including risks of refusing treatment.

  • 4.

    To participate actively in agreed upon decisions regarding your health care.

  • 5.

    To notify your doctor or nurse if you have any concerns about your care and if you notice, or think you notice any changes in your health.

  • 6.

    To ask promptly for a clarification if you do not understand what is asked of you, or why it is asked.

  • 7.

    To let your doctor or nurse know if you are concerned about a treatment, or if you feel you cannot or will not follow certain treatment plan and to be responsible for the consequences if you refuse treatment or do not follow instructions.

  • 8.

    To examine your bill and ask any questions you may have regarding the charges or methods of payments, and for assuring that the financial obligations of your health care are fulfilled as promptly as possible and that updated insurance information has been provided.

  • 9.

    To follow Center rules and regulations affecting patient care and conduct, to be considerate of other patients and center staff, and to assist in controlling the noise and the number of your visitors.

  • 10.

    Keeping appointments or notifying the health care provider when unable to do so.

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