RESOURCES
Patient RESPONSIBILITIES: 1. You are expected to provide complete and accurate information, including your full name, address, home telephone number, date of birth, Social Security number, insurance carrier and employer, when it is required. 2. You should provide the health care facility or your doctor / dentist with a copy of your advance directive if you have one.
3. You are expected to provide complete and accurate information about your health and medical history, including present condition, past illnesses, hospital stays, medicines, vitamins, herbal products, and any other matters that pertain to your health, including perceived safety risks.
4. You are expected to ask questions when you do not understand information or instructions. If you believe you can’ t follow through with your treatment plan, you are responsible for telling your doctor / dentist. You are responsible for outcomes if you do not follow the care, treatment, and services plan.
5. You are expected to actively participate in your pain management plan and to keep your doctors / dentist and nurses informed of the effectiveness of your treatment. 6. Please leave valuables at home and only bring necessary items. 7. You are expected to treat all staff, other patients and visitors with courtesy and respect; abide by all UAB rules and safety regulations; and be mindful of noise levels, privacy and number of visitors. 8. You are expected to provide complete and accurate information about your health insurance coverage and to pay your bills in a timely manner. 9. You are expected to keep appointments, be on time for appointments, and to call your health care provider if you cannot keep your appointments.
* This information is available for the sight-impaired and in Spanish.
Nondiscrimination And Language Accessibility Notice
Discrimination is Against the Law UAB Medicine complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex( including pregnancy or related conditions; sexual orientation; gender identity, and sex stereotypes). UAB Medicine does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.
UAB Medicine:
• Provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as:- Qualified interpreters- Written information in other formats( large print, audio, accessible electronic formats, other formats).
• Provides free language assistance services to people whose primary language is not English, which may include:- Qualified sign language interpreters- Information written in other languages.
If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact 205-934-2273.
If you believe that UAB Medicine has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with the UAB Medicine Civil Rights Coordinator. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, UAB Medicine Civil Rights Coordinator, is available to help you.
John Whitaker Building Attention: UAB Medicine Civil Rights Coordinator 500 22nd Street South 4th Floor, Suite 406 Birmingham, AL 35233 Phone: 205-731-9863, Fax: 205-801-8468 Email: uabmedicinecompliance @ uabmc. edu
You can also file a civil rights complaint with the U. S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at ocrportal. hhs. gov / ocr / portal / lobby. jsf, or by mail or phone at:
U. S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D. C. 202011 Phone: 800-368-1019, 800-537-7697( TDD)
20 Patient & Visitor Guide
* Complaint forms are available at hhs. gov / ocr / office / file / index. html.