Hospice Patient Rights and Responsibilities
| Color | White |
|---|---|
| MPN | 3531 |
| Brand | Briggs Health Care |
| Packaging | 100 per pad |
| Size | 8 1/2In x 11In |
Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details.
This form is used to inform the patient of his/her rights and responsibilities, in writing and orally, in advance of furnishing care during the initial evaluation visit. Areas addressed are respect and confidentiality, financial responsibilities, self-determination rights, complaint process, and the patient's responsibilities.
This form is left with the patient/family and used as a basis to demonstrate that the written requirement to educate/ inform the patient/family about their rights and responsibilities has been met.
This form may also be used for staff orientation to patient rights and responsibilities.
- Size: 8 1/2" x 11"
- White paper with black ink
- Printed two sides
- 100 per pad
- Revised January 2018
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