Experiencing a mental health crisis? Contact Mass Behavioral Health Line:

Access our new Patient Portal: MyChart

Patient Forms

Patient Rights and Responsibilities

Patient Rights

  • Confidential treatment of all information about your care except as required by state law.
  • Privacy during any interview, exam, or treatment.
  • Refusal to be examined, observed, or treated by students or staff without affecting your access to care.
  • Refusal to serve as a research subject.
  • Access to your health record as prescribed by law and the Center’s policy.
  • Privacy respecting the source of payment for care and detailed explanation of all charges.
  • Assistance and information about any health center bills or costs for services, or financial assistance and free health care if you are eligible.
  • Information about the relationship, if any, between the Center or its providers and any other health care facility or educational institution.
  • A friend, relative, or advocate who can act on your behalf during your health center visits.
  • Lifesaving treatment, even if you don’t have insurance or cannot pay.
  • Information about all the ways breast cancer can be treated (if you have breast cancer).
  • Assistance and information about emergency contraception (if you are a female rape victim).
  • Full information about Health Center services and policies.
  • Be treated with respect and dignity.
  • Courteous, convenient communication.
  • Information about the name and qualifications of the persons involved with your care.
  • Convenient appointment times, prompt attention, and an explanation if you are kept waiting.
  • Consultation from another provider, if desired.
  • Freedom to choose your provider or facility to the extent we are able to accommodate that choice.
  • Ability to take part in all decisions regarding your care, with explanations for examinations and tests.
  • Evaluation and effective management of pain, including information about options for pain relief.
  • An interpreter at no cost to you.
  • Prompt response to any reasonable requests.

Patient Responsibilities

  • Provide an accurate and complete health history.
  • Your provider may base many of his/her
  • recommendations on this information.
  • Inform Family Health Center if health care instructions provided are not clear or easily understood.
  • Bring necessary personal and health coverage
  • information to every visit.
  • Help Family Health Center to meet financial obligations by keeping health insurance up to date and by paying charges and co-payments promptly.
  • Treat Family Health Center staff, other patients/
  • visitors, facilities and their property with respect and dignity.
  • Follow the rules and regulations of the Health Center.

Patient Forms

Questions? Connect with our team by reaching out on our Contact Page.