Legal

Patient Rights and Responsibilities

As a Patient, Guardian or Other Designated Legal Representative, You Have the Right:

Access to Care

To receive considerate and respectful care without discrimination based on race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation and gender identity or expression; and with recognition of all state- sanctioned marriages and spouses for purposes of compliance with the Conditions of Participation, regardless of any laws to the contrary of the state or locality where the facility is located.
To expect competent care.
To consult with a specialist at your own request and expense.

Personal Privacy

To have your personal dignity and privacy respected.
To personal and informational privacy within the law.
To appoint a designated legal representative who will participate in your care and make decisions on your behalf should you be unable or unwilling to do so.
To have a support person present during your care, provided it does not infringe on the rights and safety of others or interfere with care processes if you have a disability as defined by the Americans with Disabilities Act (ADA).
To receive visitors of your choosing and withdraw or deny your consent to receive such visitors at any time.
To communicate by phone and/or in writing with those who cannot visit.

Security

To receive care in a safe setting and to be free from all forms of abuse and harassment.
Be free from restraints of any form that are not medically necessary.

Concerns, Complaints and Grievances

To receive information about the practice/clinic’s mechanism for the initiation, review and resolution of patient complaints/grievances, through written material or public postings.
To voice complaints and recommend changes without being subject to coercion, discrimination, reprisal, or unreasonable interruption of care.
To report a grievance relating to patient care and be informed as to the organization’s resolution of such, including a written notification by the organization’s representative listing the steps taken to investigate, the results of the process, and the date the process was completed.
To file a complaint or grievance involving Gallardo's Clinic: Call the Practice Manager at 706-529-3009 or visit https://www.gallardosclinic.com to submit an online message.

Contact the Georgia Department of Community Health by calling toll-free at 800-878-6442 or submit online at https://dch.georgia.gov/divisionsoffices/hfrd/facility-licensure/hfrd-file-complaint

Contact Office of Regulatory Services; Two Peachtree St. N.W. Atlanta, GA 30303-3142, or call 404-657-5700.

Pain Management

To have pain assessed and managed appropriately.
To participate in the development and implementation of the plan for pain management

Communication

To receive information, you can understand.
To access an interpreter and/or translation service at no charge.
To be informed about and in agreement with the need to transfer to another facility and to be accepted at the receiving facility prior to that transfer.

Access to Information

To know the facility/clinic’s rules regulating your care and conduct.
To have your physician and/or family member(s) and/or a representative of your choice notified of any referrals scheduled.
To know the names and professional titles of your caregivers and to know which physician or other provider is primarily responsible for your care.
To know that Gallardo's Clinic is a teaching facility and that some of your caregivers may be in training.
To ask your caregivers if they are in training.
To obtain complete and current information about your diagnosis (to the degree known).
To understand your treatment and prognosis, as well as any continuing health care requirements following checkout.
To request a referral to a specialist when applicable.
To be involved in the development, implementation and revision of your treatment plan/home-care plan, when applicable.
To make informed decisions regarding your care, including the right to request or refuse treatment.
To make advance directives for end of life care and have medical providers who will follow them.
To access information contained in your medical records within a reasonable time frame and without unnecessary barriers.
To receive an itemized and detailed explanation of your total bill for services rendered, regardless of the source of payment.
To say yes or no to experimental treatments, to be advised when a physician is considering you to be part of a medical research program or donor program, and to refuse or withdraw at any time without consequence to your care.
To access a financial navigator for assistance with financial questions and/or financial aid.

As a Patient, Guardian or Other Legal Designated Representative, It Is Your Responsibility:

To provide accurate and complete information about your health, including present complaints, past illnesses, hospitalizations and medications.
To inform us of changes in your condition or symptoms, including pain.
To ask questions about any part of your care or treatment you do not understand.
To speak up about your concerns to any employee as soon as possible.
To follow treatment plans recommended by the physician and/or advanced practice professional primarily responsible for your care.
To understand that if you refuse treatment or do not follow the physician’s instructions, you must accept the consequences.
To treat organizational personnel with respect and consideration, providing a safe environment in which care is given and avoiding abusive behavior which could result in dismissal from a physician practice/clinic.
To follow our rules regulating your care and conduct.
To keep your scheduled appointments or let us know if you are unable to keep them.
To respect the rights and property of others.
To respect our request that all Gallardos Clinic facilities remain smoke and vape free.
To provide a current copy of your advance directive if you have one.
To follow ADA regulations if a service animal accompanies you in our facility.
To pay your bills or make arrangements to meet the financial obligations arising from your health care as promptly as possible.