Patient Bill of Rights

As a patient at Kemet, I have the right to:

  1. Humane treatment that is courteous, considerate, and respects my personal dignity at all times.

  2. Protection of my civil rights and liberties, including no unlawful discrimination in the provision of services based on age, race, creed, sex, ethnicity, color, national origin, marital status, sexual orientation, handicap, or religion.

  3. Give informed consent for treatment based on a reasonable understanding of treatment options and their expected benefits/substantial risks, including informed written consent regarding participation in a research study.

  4. Enrolment in treatment programs with an adequate number of competent, qualified, experienced staff.

  5. Receive a plan for treatment appropriate to my needs, in accordance with clinical and regulatory guidelines.

  6. Make decisions regarding my care, including remaining informed of the content in the plan for treatment.

  7. Obtain mental health services designed to offer a reasonable opportunity for improving my condition, in accordance with standards of professional practice.

  8. Referrals to other necessary healthcare not provided by Kemet, as appropriate.

  9. Use of administrative discharge only as a last resort, and Kemet will work on your behalf leading up to this.

  10. Exercise my rights (constitutional, statutory, and civil), except when limited by findings of mental incompetency or limited by court proceedings (relating to mental illness; adjudication).

  11. Refuse treatment as a voluntary patient (if not determined mentally incompetent).

  12. Petition to refuse treatment to a court or hearing officer when deemed an involuntary patient.

  13. Strict privacy and confidentiality regarding my medical conditions and the services I receive.

  14. Inspect my medical records and transfer this information to others in accordance with Kemet policy and HIPAA.

  15. Request corrections to my medical records if they are inaccurate, irrelevant, outdated, or incomplete.

  16. Rebut information in my medical records by submitting data or notes to be added, upon review.

  17. Write an appeal to the clinic director about any limits placed on my access to my medical records.

  18. Be informed of office policies and expectations as seen in treatment agreements, patient packets, and clinic displays – for which violations may result in ineligibility for treatments or discharge.

  19. Be informed of financial aspects of treatment, including consequences of nonpayment of required fees

  20. Request a statement for the charges for a service and be informed of the policy for assessment/payment of fees.

  21. File a grievance, state an opinion, or recommendation with Kemet or the state regarding my treatment and any violations of my rights without fear of retaliation or repercussions.

  22. Consult with legal counsel or private practitioners at my own expense.

  23. Accommodations if I cannot speak English or otherwise struggle understanding consent forms for services.

The clinic director or the treatment team will address issues, such as potential rights violations or complaints.

The clinic director or the treatment team will address issues, such as potential rights violations or complaints.

Virginia Department of Health Professions, Perimeter Center
Mayland Drive, Suite 300
Henrico, VA 23233

In signing I understand the Kemet Client Bill of Rights & Responsibilities and agree to abide by it.

    Please let parent, guardian, or your personal representative sign below:

    By submitting your signature, the parties agree that this agreement may be electronically signed. The parties agree that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.