407.354.5401 Driving Directions ▸ Before Surgery Day of Surgery After Surgery Patient Forms HOME PHYSICIANS FOR PATIENTS DIRECTIONS CONTACT PATIENT’S RIGHTS AND RESPONSIBILITIES RIGHTS OF THE PATIENT: Every patient has the right to courtesy, respect, dignity, privacy, responsiveness, and timely attention to his/her needs regardless of age, race, sex, national origin, religion, cultural, or physical handicap, personal value and beliefs. Every patient has the right to every consideration of his privacy and individuality as it relates to his/her social, religious and psychological well-being. Every patient has the right to confidentiality. Has the right to approve or refuse the release of medical information to any individual outside the facility, except in the case of transfer to another health facility, or as required by law or third party payment contract. Every patient has the right to express grievances or complaints without fear of reprisals. Every patient has the right to continuity of health care. The physician may not discontinue treatment of a patient as long as further treatment is medically indicated, without giving the patient sufficient opportunity to make alternative arrangements. Every patient is provided complete information regarding diagnosis, treatment and prognosis, as well as alternative treatments or procedures and the possible risk and side effects associated with treatment. If medically inadvisable to disclose to the patient such information, the information is given to a person designated by the patient or to a legally authorized individual. Every patient has the right to make decisions regarding the heath care that is recommended by the physician. Accordingly, the patient may accept or refuse any recommended medical treatment. Every patient has the right to be informed of any research or experimental projects and to refuse participation without compromise to the patient’s usual care. Every patient has the right to appropriate treatment and care to include the assessment/managements of pain. Every patient has the right to understand facility charges. You have the right to an explanation of all facility charges related to your health care. Every patient has the right to all resuscitative measures; therefore we will not honor Advance Directives. Every patient has the right to participate in their health care treatment and decisions. RIGHTS OF THE PATIENT: Patients are responsible to be honest and direct about matters that relate to them, including answering questions honestly and completely. Patients are responsible to provide accurate past and present medical history, present complaints. Past illnesses, hospitalizations, surgeries, existence of advance directive, medication and other pertinent data. Agree to accept all caregivers without regard to race, color, religion, sex, age, gender preference, handicap, or national origin. Patients are responsible for assuring that the financial obligations for health care rendered are paid in a timely manner. Patients are responsible to sign required consents and releases as needed. Patients are responsible for their actions if they should refuse a treatment or procedure, or if they do not follow or understand the instructions given them by the physician or SurgCenter employees. Patients are responsible for keeping their procedure appointment. If they anticipate a delay or must cancel, they will notify SurgCenter as soon as possible. Patients are responsible for the disposition of their valuables, as SurgCenter does not assume the responsibility. Patients are responsible to be respectful of others, or other people’s property and the property of SurgCenter. Patients are to observe safety and no smoking regulations. PATIENT COMPLAINT OR GRIEVANCE: To report a complaint or grievance you may contact the facility administrator by phone at 407-354-5401 or by mail to the center address. Complaints and grievances may also be filed through the Florida Department of Health Services, in writing at: Florida Department of Health, 4052 Bald Cypress Way, Bin C75, Tallahassee, Florida 32399-3260 OR by phone at 850-245-4444 or by online at https://www.flhealthcomplaint.gov. All Medicare beneficiaries may file a complaint or grievance with the Medicare Beneficiary Ombudsman Online. Contact the Florida Department of Health Main Phone: 850.425.4444 Customer Service Phone: 850.425.4339 Fax: 850.488.0796 Website: http://www.floridahealth.gov/ General Email: health@flhealth.gov Customer Service Email: MQA.ConsumerServices@flhealth.gov Mailing Address: Florida Department of Health Services 4052 Bold Cypress Way Tallahassee, FL 32399 Advanced Surgery Center of Orlando, LLC 6900 Turkey Lake Rd Ste 2-5 Orlando, FL 32819 Fax: 407-354-5403 © Copyright 2021 Advanced Surgery Center of Orlando. All rights reserved. Site design by WDS. Contact Home