2 minutes
Every patient who is admitted to the hospital has the right to fill out the patient rights form.
Have you ever been a patient in a hospital or other medical facility?
If yes, did you feel that your rights as a patient were respected?
If not, please explain what happened that made you feel that your rights were not respected.
Do you feel that you know your rights as a patient?
If not, please list the rights you feel you are entitled to as a patient.
Have you ever been denied medical treatment?
If yes, please explain the circumstances under which you were denied treatment.
Have you ever been refused access to your medical records?
If yes, please explain the circumstances under which you were denied access to your records.