Brooklyn College Health Clinic

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Patient Form

Patient Rights and Responsibilities

You have the right to:
  1. receive considerate, respectful care.
  2. receive an explanation of your diagnosis, treatment, and prognosis in terms you can understand.
  3. receive the necessary information to participate in decisions about your care, (including the effectiveness of treatment, possible risks, side effects, and alternate methods of treatment,) and to give your informed consent before any diagnostic or therapeutic procedure is performed.
  4. refuse treatment, obtain another medical opinion, or an alternate course of treatment, and to be informed of the medical consequences of your actions.
  5. expect that personal privacy will be respected.
  6. expect that your medical records will be kept confidential and will only be released with your written consent, except in cases of medical emergency or in response to court-ordered subpoenas. (Confidentiality can be violated if an individual poses a significant threat of harm to self or others.)
  7. review your own medical records in the company of a health care professional. (These records, however, remain the property of BC Health Clinic.)
  8. know the names and positions of people involved in your care.
  9. change your clinical provider, if desired.
  10. receive full explanation of any research or experimental procedure proposed for treatment and the opportunity to give informed consent before any procedure will begin.
  11. bring any dissatisfaction to the attention of the Director of the Brooklyn College Health Clinic or the Dean of Student Life.
You are responsible for:
  1. presenting accurate information about your health history.
  2. requesting clarification whenever information or instructions are not understood.
  3. providing necessary personal information to complete your file.
  4. paying any laboratory charges billed to you.
  5. arriving on time for appointments and for providing advance notice when canceling an appointment.

Brooklyn College Health Clinic
2900 Bedford Ave, Room 114R  Brooklyn, NY 11210-2889
Telephone (718) 951-5580  Fax (718) 951-5869