Patient Rights & Responsibilities

At Siskiyou Community Health Center, we recognize the importance of treating each patient with respect and dignity, of recognizing individuality, of providing clear information and involving the patient in choices about his or her care and treatment.

Patient Rights

As a patient, you have the right to:

  • Care which recognizes and maintains your dignity and values.
  • Care, treatment and services that are within the scope and mission of Siskiyou Community Health Center
    and in compliance with law and regulation.
  • A safe care setting.
  • Care provided by competent personnel.
  • Knowing the identity and professional status of your caregivers.
  • Respect for your cultural, psychosocial, spiritual and personal values, beliefs and preferences.
  • Free qualified interpreters and/or special equipment to assist language needs.
  • Meaningful accessibility for individuals with disabilities
  • Free aids to meaningful accessibility for individuals with disabilities to communicate effectively.
  • Information about care options.
  • Freedom from all forms of abuse and harassment.
  • Transport services to access health center care.
  • Personal privacy within the law.
  • Confidentiality of your health care and billing records.
  • To receive all health care information regarding health status, including alternatives and risks.
  • To help plan your care, treatment, and services.
  • To participate in decisions about your care, treatment and services.
  • To give informed consent prior to the start of any tests, surgery, procedure or treatment. You may also
    withdraw your consent at any time.
  • To request a second opinion.
  • To create advance directives (such as a living will) and to have the intent of such directives honored to the
    extent permitted by law.
  • To have a surrogate decision maker, as allowed by law, when you are not able to make decisions about
    your care, treatment, and service.
  • To choose or change your health care provider.

To ask to review your medical records with your health care provider and to have the information explained and interpreted, request amendment to, and receive an accounting of disclosures regarding you own health information as permitted under applicable law within a reasonable time frame.

To be free of any sort of restraint unless medically necessary.

  • To voice a complaint to your health care provider without fear of reprisal.
  • To receive a timely response with the results of your complaint.
  • To request an administrative consultation and/or participate in any discussions that arise in the course of
    your care.
  • To communicate concerns by calling 541-471-3455 and ask to speak with the Chief Operations Officer.
  • To file a complaint or grievance with the Chief Compliance Officer 541-472-4713.
  • To file a grievance appeal with the Chief Compliance Officer 541-472-4713.

If not resolved, file a grievance with the U.S. Department of Health and Human Services, Office for Civil Rights. Forms are available at

  • A complete explanation of your bill.
  • To speak with a billing specialist regarding your bill, insurance, co-pays and other means of payment.
  • To communicate with a billing specialist call 541-472-4799.

This health care facility makes its services available to all individuals in the community.

Nondiscrimination Statement: Siskiyou Community Health Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, religion, sexual orientation, and inability to pay.

This health care facility does not discriminate against a patient because of age, gender, including discrimination based on pregnancy, disability, race, creed, color, national origin, or because of a patient’s coverage of health insurance in Marketplaces and other health plans.
If you believe you have been improperly denied services, contact the clinic manager for your location:

  • Grants Pass Clinic Manager – (541) 471-3455
  • Cave Junction Clinic Manager – (541) 592-4111
  • Dental Clinic Manager – (541) 479-6393
  • Outreach Program Manager – (541) 472-4743
  • Walk-In Clinic Manager – (541) 472-4705

If you believe that you have been discriminated against because of your race, color, national origin, disability, age, sex (including sex stereotyping and gender identity), or religion, you may file a complaint with the Siskiyou Community Health Center Compliance Officer at (541) 472-4713 or:

  • Electronically through the Office for Civil Rights Complaint Portal, at:
  • By mail at: U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201.
  • By phone at The Department of Health and Human Services, Office for Civil Rights toll-free at: 1-800-368-1019, TDD: 1-800-537-7697.

Patient Responsibilities

Help us take care of you. Please know that we support you in meeting your responsibilities during your stay, such as:

  • Providing accurate and complete medical information to your health care providers.
  • Understanding your treatment plan, asking questions, and informing staff when answers are not
    understandable or your treatment plan cannot be followed.
  • Reporting any change in your condition.
  • Informing us of Advance Directives.
  • Participating in your care.
  • Following the advice of your health care team to the best of your ability.
  • Accepting the consequences of your decisions if you refuse to follow recommended treatments and
  • Respecting the needs, rights and property of other patients, family members and caregivers.
  • Being mindful of noise levels.
  • Refraining from all forms of abuse and harassment.
  • Knowing the extent of your insurance coverage.
  • Knowing your insurance requirements such as pre-authorization, deductibles and co-payments.
  • Calling the billing office with questions or concerns.
  • Meeting your financial obligations.

Siskiyou Community Health Center is a weapons, tobacco and drug abuse – Free Zone.

This institution is an equal opportunity provider and employer.