Purpose:  To acknowledge patients’ rights and responsibilities and Inland Pain Medicine’s responsibility to respond to each patient with personal dignity and respect.


All patients have the right to considerate, respectful care at all times and under all circumstances, with recognition of their personal dignity and autonomy.   Inland Pain Medicine will continue to develop, implement, and adhere to policies intended to assure practices that will respect the rights of all patients regardless of race, creed, sex, national origin, religion, or age.

A. Access to Treatment
Within the capacity and scope of its mission and services, Inland Pain Medicine respects and supports the patient’s right to impartial access to treatment and services that are consistent with relevant laws and regulations and medically indicated, regardless of race, creed, sex, national origin, religion, or age.

B. Personal Privacy
The right of the patient to personal, visual, and auditory privacy will be honored to the extent reasonable.

C. Identity
The patient has the right to know the identity and professionals status of the individuals providing service to him/her and to know which physician or other practitioner is primarily responsible for his/her care.

D. Confidentiality
The right of the patient to confidentiality will be honored, within the limits of the law.  This includes the patient’s location, identity, and medical record and applies to the sharing of information within Inland Pain Medicine with outside sources.

E. Self-Determination
The patient has a right to make decisions concerning his/her care, including advance directives and the refusal of care.  Should the patient be unable to make these decisions, the patient may appoint a surrogate to act on his/her behalf.

F. Concerns, Complaints or Grievances
Regarding Services, Patient Safety, or Quality of Care
Patients, their family members/legal representatives, and the general public have a right to register a complaint or grievance regarding services, patient safety, or the quality of care received.  Individuals are encouraged to contact the administration directly through (909) 798 – 0348 prior to contacting outside agencies.

G. Ethical Consideration
Conflicts of values, principles or interest in the clinical setting will be resolved through the collaboration of the professional staff and the patient, and when appropriate, the patient’s family or other representative.

H. Access to Information
The patient has the right to access complete and current information regarding his/her diagnosis, treatment, any known prognosis, and outcomes of care including unanticipated outcomes of care.

I. Consultation
The patient has the right to request consultation with another specialist. This may be arranged through referral by the patient’s physician or pain specialist.

J. Refusal of Care
A patient has the right to refuse care, treatment or services according to the laws of California.

K. Freedom from Abuse
Patients have a right to be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation from staff, students, volunteers, or other patients.

L. Disclosures
The patient has the right to access and receive an accounting of all disclosures regarding his/her health information as permitted by law.

A. Provision of Information

The patient has the responsibility to provide, to the best of his/her knowledge, accurate and complete information on all matters relating to his/her health.

B. Asking Questions

Patients are responsible for asking questions when they do not understand what they have been told about their care or what they are expected to do.

C. Following Instructions

The patient is responsible for following the treatment plan mutually agreed upon by the patient, the physicians, and other clinicians involved in the patient’s care.  The patient has the responsibility to express any concerns they have in their ability to follow or comply with the proposed care or treatment.

D. Refusal of Treatment/Accepting Consequences

The patient is responsible for his/her actions and the outcomes of those actions if he/she refuses treatment or does not follow the agreed upon treatment plan.

E. Inland Pain Medicine Charges

The patient is responsible for assuring that the financial obligations of his/her health care are fulfilled as promptly as possible.

F. Inland Pain Medicine Rules and Regulations

The patient is responsible for following Inland Pain Medicine rules and regulations affecting patient care and conduct.

G. Respect and Consideration

The patient is responsible for being respectful of the property and privacy of others and of the Medical Center and its employees and shall conduct himself/herself accordingly.

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