Client Rights Notification
As a recipient of services at our facility, we would like to inform you of your rights as a client. The information contained within explains your rights and the process of complaining if you believe your rights have been violated.
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Your rights as a client
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Complaints. We will investigate your complaints.
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Suggestions. You are invited to suggest changes in any aspect of the services we provide.
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Civil rights. Your civil rights are protected by federal and state laws.
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Cultural/spiritual/gender issues. You may request services from someone with training or experiences from a specific cultural, spiritual, or gender orientation. If these services are not available, we will help you in the referral process.
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Treatment. You have the right to take part in formulating your treatment plan.
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Denial of services. You may refuse services offered to you and be informed of any potential consequences.
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Record restrictions. You may request restrictions on the use of your protected health information; however, we are not required to agree with the request.
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Availability of records. You have the right to obtain a copy and/or inspect your protected health information; however, we may deny access to certain records. If so, we will discuss this decision with you.
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Amendment of records. You have the right to request an amendment in your records; however, this request could be denied. If denied, your request will be kept in the records.
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Medical/legal advice. You may discuss your treatment with your doctor or attorney.
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Disclosures. You have the right to receive an accounting of disclosures of your protected health information that you have not authorized.
Your right to receive information
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Medications used in your treatment. We will provide you with information describing any potential risks of medications prescribed at our facility.
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Costs of services. We will inform you of how much you will pay.
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Termination of services. You will be informed as to what behaviors or violations could lead to termination of services at our clinic.
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Confidentiality. You will be informed of the limits of confidentiality and how your protected health information will be used.
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Policy changes.
Our ethical obligations
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We dedicate ourselves to serving the best interest of each client.
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We will not discriminate between clients or professionals based on age, race, creed, disabilities, preferences, or other personal concerns.
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We maintain an objective and professional relationship with each client.
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We respect the rights and views of other mental health professionals.
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We will appropriately end services or refer clients to other programs when appropriate.
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We will evaluate our personal limitations, strengths, biases, and effectiveness on an ongoing basis for the purpose of self-improvement. We will continually attain further education and training.
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We respect various institutional and managerial policies but will help to improve such policies if the best interest of the client is served.
Client’s responsibilities
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You are responsible for your financial obligations to the Practice as outlined in the Payment Contract for Services.
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You are responsible for complying with the policies of the Practice.
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You are responsible to treat staff and fellow clients in a respectful, cordial manner.
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You are responsible to provide accurate information about yourself.
What to do if you believe your rights have been violated
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If you believe that your client rights have been violated, contact Practice Owner and Psychotherapist, Dr. Charmaine Samuda DSW, LCSW via email at info@bestpracticepsychotherapy.com or telephone: 203-553-9957.