PACS Urgent Care
Patient Rights & Responsibilities
Your Rights as a Patient
At PACS Urgent Care, we are committed to providing care that respects your dignity, autonomy, and privacy. As our patient, you have the following rights:
1. Right to Respectful and Non-Discriminatory Care
You have the right to receive care that is compassionate, respectful, and free from discrimination based on race, color, religion, sex, national origin, disability, age, sexual orientation, gender identity, or ability to pay.
2. Right to Information About Your Care
You have the right to be informed about your diagnosis, treatment options, risks, benefits, and alternatives in a language and format you can understand. You may ask questions at any time and receive clear, honest answers from your care team.
3. Right to Participate in Treatment Decisions
You have the right to participate in decisions about your care, to accept or refuse any recommended treatment, and to be informed of the likely consequences of refusing treatment.
4. Right to Privacy and Confidentiality
Your medical and personal information is confidential. We protect your privacy in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state law. For details, see our Notice of Privacy Practices.
5. Right to Access Your Medical Records
You have the right to inspect and receive a copy of your medical records within the timeframes established by law. To request your records, contact our office at the numbers below. We may charge a reasonable fee for copies.
6. Right to Request Amendments to Your Records
If you believe your health information is incorrect or incomplete, you may request that we amend it. We will respond in writing and explain our decision if we decline.
7. Right to an Accounting of Disclosures
You may request a list of instances where we disclosed your health information for purposes other than treatment, payment, or health care operations.
8. Right to Request Restrictions on Use of Your Information
You may request restrictions on how we use or share your health information. We will honor your request to restrict disclosures to your health plan when you pay entirely out of pocket for a service.
9. Right to Confidential Communications
You may request that we contact you at a specific phone number or address, or in a specific way, if you have a concern about confidentiality. We will accommodate reasonable requests.
10. Right to File a Complaint Without Retaliation
If you believe your rights have been violated or you are dissatisfied with your care, you have the right to file a complaint. We will not retaliate against you in any way for doing so.
How to Exercise Your Rights
To exercise any of the rights described above, please contact us:
PACS Urgent Care — Privacy Officer / Patient Services
Alexandria: 3481 N Beauregard St, Alexandria, VA 22302
Phone: (571) 290-3614
Ruther Glen: 17067 Merchants Dr, Ruther Glen, VA 22546
Phone: (804) 220-6044
Website: pacsurgentcare.com
Your Responsibilities as a Patient
To help us provide you with the best care possible, we ask that you:
- Provide accurate and complete information about your health, medications, and medical history
- Inform us of any changes to your insurance, address, or contact information
- Ask questions when you do not understand your diagnosis, treatment, or instructions
- Follow the treatment plan agreed upon with your provider, and inform us if you choose not to
- Treat our staff and other patients with respect
- Meet your financial obligations for services rendered, or discuss payment arrangements with us
- Arrive on time for scheduled appointments and notify us promptly if you need to cancel or reschedule
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