Patient Rights & Responsibilities

As a Patient, You Have the Right To:

• Become informed of rights as a patient in and attempts will be made to communicate in the language or manner primarily used by you. A list of these patient’s rights, which shall be posted within Northeast Wisconsin Foot & Ankle Associates and on their website so that such rights may be read by all patients.
• Be treated with dignity and receive considerate and respectful care provided in a safe environment.
• Remain free from all forms of abuse or harassment, seclusion or restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience or retaliation by staff.
• Exercise these rights without regard to age, race, disability, sex or cultural, economic, education, or religious background or the source of the payment for care given.
• Receive information from the physician about the illness, course of treatment and prospects for recovery in terms that the patient can understand.
• Participate actively in decisions regarding medical care. To the extent permitted by law, this includes the right to request and/or refuse treatment.
• Express concern regarding your care or any violation of your rights and that in doing so will not adversely affect the quality of care provided.
• Change physicians if desired, either within Northeast Wisconsin Foot & Ankle Associates or another physician of the patient’s choice.
• Confidential treatment of all communications and records pertaining to patient’s care and visit at Northeast Wisconsin Foot & Ankle Associates. The patient’s written permission shall be obtained before medical records can be made available to anyone not directly concerned with patient’s care.
• Full disclosure of the privacy policy.
• Access information contained in your medical records within a reasonable time frame in accordance with state/federal laws and regulations.
• Examine and receive an explanation of the bill regardless of source of payment. Information of payment policies and fees for service are available.
• If eligible for Medicare, to know upon request and in advance of treatment whether a healthcare provider or facility accepts the Medicare assignment rate.

• Expect reasonable safety insofar as Northeast Wisconsin Foot & Ankle Associates practice and environment are concerned.
• Have all patient’s rights apply to the person who may have legal responsibility to make decisions regarding medical care on behalf of the patient.
• Receive appropriate information regarding provider credentialing.

As a Patient, You Are Responsible For:

• Provide accurate and complete information about present complaints past illnesses, hospitalizations, any medications, including over-the-counter products and dietary supplements and any allergies or sensitivities, and other matters related to your health.
• Ask questions when you do not understand your diagnosis or what is expected of you is not clearly understood.
• Follow the treatment plan established by the physician, including the instructions of nurses and other health professionals as they carry out the physician’s orders.
• Provide a responsible adult to transport the patient home from Northeast Wisconsin Foot & Ankle Associates and remain with the patient for 24 hours if required by the physician.
• Keep appointment or notify Northeast Wisconsin Foot & Ankle Associates or physician when unable to keep an appointment.
• Accept responsibility for any actions resulting from the refusal to follow treatment or physician’s orders.
• Inform the physician about any living will, medial power of attorney or other directive that could affect the patient’ s care.
• Accept and ensure that the financial obligations of care are fulfilled as promptly as possible.
• Follow Northeast Wisconsin Foot & Ankle Associates policies and procedures.
• Be considerate of the rights of other patients and Northeast Wisconsin Foot & Ankle Associates personnel.
• Be respectful of personal property and that of other persons at Northeast Wisconsin Foot & Ankle Associates.