Patients’ Rights and Responsibilities Union Health Services, Inc. respects your rights as a patient and wants you to understand your responsibilities as a partner in your care. It is your right as a Union Health Service patient to: 1. Receive considerate and respectful care. 2. Receive care without regard to race, religion, color, national origin, gender, age, sexual orientation, or disability. 3. Know upon request, the identity of physicians, nurses and others involved in your care, e.g., resident physicians, student nurses, and other supervised health care providers in training may become involved in your care and treatment. You have the right to ask if any of your health care providers are in training. 4. Receive information about your diagnosis, condition, and treatment, to make informed decisions regarding your healthcare, and to refuse treatment to the extent permitted by law, however, to be informed also of the possible consequences of the refusal. 5. Be provided “guidance documents”, to assist in formulating advance directives and have them followed as permitted by law. 6. Receive your care in an environment that respects personal privacy and safety. 7. Receive appropriate care and services as medically indicated within the capacity of the health care facility. 8. Express concerns or grievances regarding your care to the Member Services department or the Medical Director’s office. 9. Expect that the confidentiality of your clinical and personal records will be maintained pursuant to local and Federal law. 10. Request to review, restrict and amend your medical records as provided for by law. 11. Appeal any decisions by Union Health Service affecting payment, pursuant to the provisions of your plan’s subscriber certificate.

It is your responsibility as a Union Health Service patient to: 1. Provide accurate and complete information about all matters pertaining to your health, including symptoms, allergies, medications and past or present medical problems. 2. Participate to the best of your ability in making decisions about your treatment, and to follow the instructions and advice of your health care team. If you refuse treatment or do not follow the instructions or advice, you must accept the consequences of your actions. 3. Ask questions of the health care team if you do not understand information about your care and treatment, and to inform your physician if you anticipate problems in following the prescribed treatment. 4. Recognize the impact of your lifestyle on your personal health. 5. Report changes in your condition or symptoms to a member of the healthcare team. 6. Act in a considerate and cooperative manner and to respect the rights and property of others, including those receiving and providing care. 7. Follow the rules and regulations of the health care facility. 8. Keep scheduled appointments or, when necessary, to cancel them in advance if at all possible. Questions or Concerns? You and your family should feel you can always voice your concerns. The first step is to discuss your concerns with your doctor, nurse, or other caregiver. If you have concerns that are not resolved, please contact our Member Services Department at 312-423-4200 x 3379, 3292 or 5304.