Patient Rights & Responsibilities

01Your rights

• Respect. To be treated with dignity and courtesy, without discrimination of any kind. See our Nondiscrimination Notice.
• Privacy. To have your health information protected as described in our Notice of Privacy Practices, and to have privacy during exams.
• Information. To get clear explanations of your condition, treatment options, risks, benefits, and costs, in a language you understand. Free interpreters are available.
• Decisions. To take part in decisions about your care, to ask questions, to get a second opinion, and to refuse treatment after learning the likely results.
• Your records. To see and get a copy of your medical records, and to ask us to correct them.
• Costs. To know what your care will cost before you receive it, including a Good Faith Estimate if you are self-pay.
• Safety. To receive care in a safe setting, free from abuse or harassment.
• Accommodations. To request reasonable accommodations for a disability. See Accessibility.
• Concerns. To raise a concern or complaint without it affecting your care.

02Your responsibilities

• Share accurate information about your health, symptoms, medications, allergies, and past care.
• Follow your care plan, or tell us if you can’t or don’t want to, so we can work out another approach.
• Keep appointments, arrive on time, and give at least 24 hours’ notice to cancel. Repeated no-shows may result in a fee.
• Pay on time for copays, deductibles, self-pay charges, and membership fees, as described in our Forms & Policy.
• Keep your information current, including your address, phone number, insurance, and pharmacy.
• Treat everyone with respect, including staff, other patients, and visitors. We do not tolerate threats, violence, harassment, or abusive language.
• Use the right channel. Call 911 for emergencies. Use the Patient Portal, not website forms, for medical questions.

03Ending the patient relationship

You may choose to leave our practice at any time, and we will transfer your records at your request. We may end a patient relationship for reasons such as threatening or abusive behavior, repeated missed appointments, nonpayment, or fraud. If we do, we will notify you in writing, continue to provide urgent care for a reasonable period, usually 30 days, and help you find a new physician and transfer your records.

04How to raise a concern

1. Talk with any team member, or ask to speak with our Clinic Manager.
2. Put your concern in writing to the address below, or email contact@luckycharmprimarycare.com. We aim to respond within 10 business days.
3. For privacy concerns, contact our Privacy Officer at the same address. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
4. You may file a complaint about a physician with the Texas Medical Board at tmb.state.tx.us or 1-800-201-9353.