Prior to receiving care at the Ashe Center, patients shall be reminded of their patient responsibilities (such as providing complete and accurate information to the Ashe Center providers; accepting personal financial responsibility for any charges not covered by his/her insurance; remaining respectful of all Ashe Center providers and staff, as well as other patients).
Policy at The Ashe Center
- The Arthur Ashe Center supports the patients’ shared responsibility in the care-giving process through the identification of rights and responsibilities of the patient.
- This information shall be publicized and made available to patients as well as staff in the form of publications on display.
- Patients have these rights without regard to sex, economic status, educational background, race, ethnicity, color, age, religion, ancestry, national origin, sexual orientation, gender identity or expression, marital status, disability, or source of payment for care.
Patient Rights at The Ashe Center
- Patients are treated with respect, consideration, and dignity;
- Patients are informed of their right to change providers if other qualified providers are available;
- Patients are provided appropriate privacy
- Patient disclosures and records are treated confidentially, and patients are given the opportunity to approve or refuse their release, except when release is required by law; and
- Patients are provided, to the degree known, complete information concerning their diagnosis, evaluation, treatment and prognosis. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient or to a legally authorized person.
- Patients are given the opportunity to participate in decisions involving their health care, except when such participation is contraindicated for medical reasons
- The patient’s family is included, as appropriate, in the patient care decisions, treatment and education.
- Patients have the right to receive adequate information necessary to provide informed consent prior to the state of any procedure, test or treatment;
- Patients have the right to refuse treatment, or to ask for a second opinion, or an alternative course of treatment, and to be informed of the medical consequences of such actions;
- Patients have the right to ask for a prescription for an outside pharmacy, or to have diagnostic tests performed at another facility;
- Patients have the right to access personal medical records, as described in the Ashe Medical Records Manual;
- Patients have the right to receive an explanation of any service changes incurred;
- Patients have the right to information about the qualifications and credentials of their own Ashe Center clinician; and
- Patients have the right to confidentially comment on their care and receive a response, if requested.
- Patients have the right to formulate advance directives. All patients' rights apply to the person who has legal responsibility to make decisions regarding medical care on behalf of the patient
- Patients have the right to file a grievance through:
- The UCLA Ashe Center by visiting www.studenthealth.ucla.edu/patient-feedback. Your grievance will be reviewed and responded to within 30 days.
- The Accreditation Association for Ambulatory Health Care (AAAHC) by calling (847) 853-6060 or emailing firstname.lastname@example.org. You can also write to AAAHC, 5250 Old Orchard Road, Suite 200, Skokie, IL 60077.
- The Medical Board of California (regarding the conduct of a physician) by calling (800) 633-2322 or (916) 263-2382, or writing to: Medical Board of California, Central Compliant Unit, 2005 Evergreen Street, Suite 1200, Sacramento, CA 95815.
- U.S. Department of Health and Human Services with the Office for Civil Rights (a civil rights complaint), electronically at the Office for Civil Rights Complaint Portal: orcportal.hhs.gov/ocr/smartscreen/main.isf, by phone at 800-368-1019, 800-537-7697 (TDD) or mail: U.S. Department of Health and Human Services 200 Independence Ave, SW Room 509F, HHH Building Washington, D.C. 20201. Complaint forms are at hhs.gov/ocr/complaints/index.html
Patient Responsibilities at The Ashe Center
- Patients have the responsibility to be respectful and considerate to clinicians and other Ashe Center staff;
- Patients have the responsibility to provide complete, honest information to their clinician so they can make the best decisions about the patient’s care;
- Patients have the responsibility to ensure a clinician understands the patient’s health concerns;
- Patients have the responsibility to condor the information they are given about their care;
- After agreeing to a course of treatment, patients have the responsibility to themselves and their clinicians to follow the prescribed instructions, including completing medication and returning for follow-up appointments; and
- Patients have the responsibility to be cost-conscious, to use The Ashe Center services wisely and to pay any bills to The Ashe Center or external providers promptly.
- Provide a responsible adult to transport the patient home from the facility and remain with the patient for 24 hours, if required by the provider.
If you have any questions or concerns about the treatment or care you received at The Ashe Center, please submit feedback on our website, www.studenthealth.ucla.edu under “Contact Us” or at our patient feedback kiosks at the entrance of each floor.
At The Ashe Center, we understand that certain medical exams and procedures are more sensitive than others and we want to make sure that you are as comfortable as possible. You, or your provider, may choose to have a medical chaperone present during a physical examination, or at any time during your medical visit. A medical chaperone is a specially trained member of the Ashe Center clinical team whose job it is to enhance the patient’s comfort, safety, privacy, security, and dignity during your visit. The chaperone will stand in a location where they are able to observe the exam, and assist as needed. It is Ashe policy to have a chaperone present during all sensitive examinations (involving the genitals, anus, or breasts) or when you must be fully disrobed, unless you decline.
If you have any questions or concerns about the quality of care you have received at The Ashe Center, please submit any confidential inquiries to Ashe Center Care Manager, Katherine Mulligan, email@example.com. You can also submit anonymous feedback at any time.
An advance directive is a document by which a person makes provision for health care decisions in the event that, in the future, he/she becomes unable to make those decisions.
There are two main types of advance directives — the “Living Will” and the “Durable Power of Attorney for Health Care.” There are also hybrid documents which combine elements of the Living Will with those of the Durable Power of Attorney.
Students can get help with creating an Advanced Directive through Student Legal Services. Student Legal Services charges $50 for this type of consultation/assistance and students can make an appointment via their website, or by calling the office at (310)-825-9894.
If you chose to complete an Advanced Directive, please provide both the Ashe and UCLA Health medical records departments with a copy of the document so it can be added to your chart in both locations.
For more information on Advance Directives, please refer to the State of California Department of Justice, Office of the Attorney General resource page.