Consumer Rights
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Your Rights as a Consumer Of Jireh Counseling and Consulting Services Mental Health, Developmental Disabilities, and Addictive Diseases State and Federal laws protect your rights as a consumer of Jireh Counseling and Consulting Services treatment programs. Below is a simplified outline of those rights: Your rights include:
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The right to receive care suited to your needs.
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The right to receive services that respect your dignity and protect you health.
•
The right to pertinent information, including the benefits and risks of your treatment, in sufficient time to make informed decisions.
•
The right to participate in planning your own program, and the right to request choice over the composition of the service delivery team.
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The right to refuse service, unless a physician or licensed psychologist feels that refusal would be unsafe for you and others.
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The right of referral to legal entities for appropriate representation, and to self-help and advocacy support services.
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The right to prompt and confidential services even if you are unable to pay.
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The right to request an opportunity to inspect, copy, and correct your records).
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The right to exercise all civil, political, personal, privacy and property rights to which you are entitled to as a citizen.
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The right to remain free of physical restraints or time-out procedures unless such measures are required for providing effective treatment or for protecting your safety or the safety of others.
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The right to be free of physical abuse, including sexual abuse, and physical punishment.
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The right to remain free of psychological abuse, including humiliating, threatening, and exploiting actions.
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The right to file a complaint if you think any of these rights have been restricted or denied. Information on how to file a complaint or contact your Consumer's Rights Representatives is presented on a poster near the reception desk.
CR100—Consumer Rights
RevOct 08
Consumer Rights and Responsibilities Consumer Receipt & Acknowledgement of Rights: My signature below certifies that I have read AND understand completely what my rights are as a participant in Jireh Counseling And Consulting Services, Inc. program. ___________________________ Consumer Signature
______________ Date
___________________________ Consumer Name (Print) ____________________________ Staff Witness
CR100—Consumer Rights
_____________ Date
RevOct 08
•
The right to receive care suited to your needs.
•
The right to receive services that respect your dignity and protect you health.
•
The right to pertinent information, including the benefits and risks of your treatment, in sufficient time to make informed decisions.
•
The right to participate in planning your own program, and the right to request choice over the composition of the service delivery team.
•
The right to refuse service, unless a physician or licensed psychologist feels that refusal would be unsafe for you and others.
•
The right of referral to legal entities for appropriate representation, and to self-help and advocacy support services.
•
The right to prompt and confidential services even if you are unable to pay.
•
The right to request an opportunity to inspect, copy, and correct your records).
•
The right to exercise all civil, political, personal, privacy and property rights to which you are entitled to as a citizen.
•
The right to remain free of physical restraints or time-out procedures unless such measures are required for providing effective treatment or for protecting your safety or the safety of others.
•
The right to be free of physical abuse, including sexual abuse, and physical punishment.
•
The right to remain free of psychological abuse, including humiliating, threatening, and exploiting actions.
•
The right to file a complaint if you think any of these rights have been restricted or denied. Information on how to file a complaint or contact your Consumer's Rights Representatives is presented on a poster near the reception desk.
CR100—Consumer Rights
RevOct 08
Consumer Rights and Responsibilities Consumer Receipt & Acknowledgement of Rights: My signature below certifies that I have read AND understand completely what my rights are as a participant in Jireh Counseling And Consulting Services, Inc. program. ___________________________ Consumer Signature
______________ Date
___________________________ Consumer Name (Print) ____________________________ Staff Witness
CR100—Consumer Rights
_____________ Date
RevOct 08
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