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UCLA Arthur Ashe Student Health & Wellness Center

Prior to Care

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 their insurance; remaining respectful of all Ashe Center providers and staff, as well as other patients).

What to Expect

Policy at The Ashe Center

  1. The Arthur Ashe Center supports the patients’ shared responsibility in the care-giving process through the identification of rights and responsibilities of the patient.
  2. This information shall be publicized and made available to patients as well as staff in the form of publications on display.
  3. 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

  1. Patients are treated with respect, consideration, and dignity;
  2. Patients are informed of their right to change providers if other qualified providers are available;
  3. Patients are provided appropriate privacy;
  4. Patients have a right to interpretation services;
  5. 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;
  6. 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;
  7. Patients are given the opportunity to participate in decisions involving their health care, except when such participation is contraindicated for medical reasons;
  8. The patient’s family is included, as appropriate, in the patient care decisions, treatment and education;
  9. Patients have the right to receive adequate information necessary to provide informed consent prior to the state of any procedure, test or treatment;
  10. 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;
  11. Patients have the right to ask for a prescription for an outside pharmacy, or to have diagnostic tests performed at another facility;
  12. Patients have the right to access personal medical records, as described in The Ashe Center Medical Records Manual;
  13. Patients have the right to receive an explanation of any service charges incurred;
  14. Patients have the right to information about the qualifications and credentials of their own Ashe Center clinician, and;
  15. Patients have the right to confidentially provide feedback on their care and receive a response, if requested;
  16. 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;
  17. 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 info@aaahc.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

  1. Patients have the responsibility to behave respectfully toward all health care professionals and staff, as well as other patients and visitors;
  2. Patients have the responsibility to provide complete and accurate information to the best of their ability about their health, any medications taken, including over the counter products and dietary supplements, and any allergies or sensitivities to their clinician so that they can make the best decisions about the patient’s care;
  3. Patients have the responsibility to ensure a clinician understands the patient’s health concerns;
  4. Patients have the responsibility to consider the information they are given about their care;
  5. Patients have the responsibility to follow the agreed-upon treatment plan prescribed by their provider and participate in their care, including completing medication and returning for follow-up appointments, and;
  6. 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;
  7. Patients have the responsibility to provide a responsible adult to provide transportation home and remain with the patient as
    directed by the provider or as indicated on discharge instructions;
  8. Patients have the responsibility to abide by all university policies listed here: www.policies.ucla.edu.

If you have any questions or concerns about the treatment or care you received at The Ashe Center, please submit feedback on our website or at our patient feedback kiosks at the entrance of each floor.

Rights & Responsibilities Translations

Translations of this document are currently being updated. Thank you for your patience.