Information regarding your presumptive diagnosis, treatment and prognosis in terms
you can understand.
All information needed to give informed consent for any procedure or treatment.
Refuse treatment and be informed of the potential consequences.
Expect that your personal privacy will be respected.
Expect that your clinical records will be kept strictly confidential and released:
With your written consent
In cases of medical emergencies or where danger to self or others is present.
For continuity of care with other medical providers (including Hazen Center staff)
In response to court-ordered subpoenas
Know the names and positions of people involved in your care by official nametag and/or
Change clinician at any time per policy/protocol.
Obtain an alternative professional opinion prior to any procedure or regarding a condition
or concern you have.
Review your College at Brockport clinical records with your clinician in accordance
Express a concern, grievance or suggestion.
Concerns and grievances should be directed to the Director of Hazen or Associate Director
of Counseling or Health.
There are cards in the Reception area and each exam room. These may be placed in the
suggestion boxes located in the Reception area and hallways, or given to any staff
member. Your name and contact information is optional.
You are responsible for:
Providing complete and accurate information about your health.
Asking questions if you do not understand your diagnosis, treatment, prognosis or
Participating in your care by following recommendations.
Keeping appointments or notify the staff as soon as possible if unable to keep appointments.
Being respectful of the staff and others present in Hazen.
Any charges billed to you, whether by Hazen or a consulting lab, pharmacy, hospital