The Patient Bill of Rights & Responsibilities

Privacy Notice

Confidentiality

Confidentiality Statement

Requesting a copy of your
Medical Record

Authorization to Exchange Medical Information by Electronic Mail

The Patient Bill of Rights and Responsibilities

The goal of Health Services is to provide all patients with high quality health care in a manner that clearly recognizes individuals' needs and rights. We also recognize that in order to accomplish this goal effectively, the student and the health care provider must work together to develop and maintain optimum health. As a result, the following student rights and responsibilities were written.

• To receive considerate care that is respectful of your personal beliefs and cultural and spiritual values.
• To have all things explained to you in terms that you can understand and to have any questions answered concerning your diagnosis, prognosis, and treatment.
• To appropriate assessment and management of your symptoms, including pain.
• To know what the diagnosis is; what the prognosis is; what treatment will be used; how risky treatment is; whether it will hurt and for how long.
• To have all the common side effects of a drug explained.
• To know the contents of your medical records through interpretation by the provider.
• To know who it is that is interviewing and examining you.
• To have explained to you ways that you can prevent your medical problem from recurring.
• To refuse to be examined or treated by health practitioners and to be informed of the consequence of such decisions.
• To be assured of the confidential treatment of disclosures and records and to have the opportunity to approve or refuse the release of such information except when release of specific information is required by law or is necessary to safeguard you or the university community.
• To be informed and asked whether you wish to participate in medical research when it is being conducted at Health Services.
• To participate in the consideration of ethical issues that arise in the provision of your care.
  
  AS A PATIENT YOU HAVE THE RESPONSIBILITY:
  
  
• To provide Health Services with information about your current sypmtoms, including pain.
• To provide Health Services with information about past illnesses, hospitalizations and medications.
• To ask questions if you do not understand the directions or treatment being given by a provider.
• To keep appointments or telephone Health Services within a reasonable time ahead if you need to cancel.
• To be respectful of others and others' property while in Health Services facility.
  
  

Privacy Notice
Health Services Privacy Notice describes how medical inforamtion about you may be used and disclosed and how you can get access to this information.

Confidentiality

Why can more than one provider see my medical record?
Release of information
What happens to my medical record once I leave Brown?
How do I request a copy of my medical record?

Confidentiality is important to us as well as to you. You can be assured of confidential treatment of your medical records and will have the opportunity to approve or refuse the release of information. You, the student, are our patient; parents do not have access to your medical records without your consent. Medical information is not released to other university staff (e.g., deans, professors, Psychological Services) without your written consent. There are a very few exceptions when release of specific information without your expressed consent is necessary in emergencies or is required by law (e.g., in court cases involving claims of insurance fraud, malpractice or liability). Each year, every staff member in Health Services signs the following legally-binding confidentiality agreement.

Health Services Employee Confidentiality Statement and Agreement

Your medical record travels with you wherever you need to go within Health Services, but it does not leave the building; neither we nor you may take your medical record (your chart) from the building. Access to medical records is limited to the staff of Health Services. All providers who work in Health Services have access to your medical record in order to assure continuity of your care; it is difficult to provide good care if we have to start from scratch each time you come in.

Why can more than one provider see my medical record?

Because we are a "group practice," each patient has one medical record that is used throughout the building; you do not have one record for medical, one for pharmacy, one for lab, etc. The concept of a group practice may be new to you and you may have questions about how many people have access to your medical records. If you previously had a pediatrician or family doctor who had a private practice, s/he probably worked with a nurse and a receptionist. In that case, those three people had access to your records; they did not share them with the doctor across town (unless she/he was also taking care of you). Your records stayed in that office.
Likewise, your medical record stays in Health Services; we do not share it with the deans, Psychological Services, your parents. But Health Services is a little different in that we have more than three people working here. Health Services' philosophy of health care emphasizes providing "continuity of care" and treating the whole person rather than individual parts or illnesses. "Continuity of care" means knowing enough about a patient's health and previous illness to provide health care that is appropriate for the patient. To do this, a provider must take into consideration the patient's medical history, other illness, medications, etc. Having one medical record instead of five facilitates continuity of care.

Regarding release of information to insurance or outside consultants: As the patient, you must sign a form to request and allow Health Services to release your medical information. On the release form you indicate what information you wish released and to whom the information should go. There is also a section of the release form that allows you to specify one of three options for specific types of information. This section states,

____ Release all information in my medical record.
____ Release all information in my medical record, except for: mental health; drug or alcohol abuse; sexually transmitted diseases; or HIV related information, including testing.
____ Release only the following specific information in such records (state illness and/or treatment and specify dates. This section states, please release/do not release...

What happens to my medical record after I leave Brown?

We are required by law to keep medical records for 5 (five) years after a student leaves Brown. The records are then destroyed. You may request a copy of your medical record anytime prior to the five-year deadline.

To Request a Copy of Your Medical Record

To request a copy of your medical record, you must fill out and sign a release of information form.

Click here for a printable copy of the Medical Record Release Form and fax it to (401) 863-7953 or
mail it to Health Services at Brown University, Box 1928, Providence, RI 02912.

There is no charge for one or two page copies (e.g., immunization record, lab results); we can mail or FAX the information. We cannot FAX your entire medical record.
If you want a copy of your entire medical record (your whole chart), there is a charge of 25 cents per page if there are more than twenty pages (the first twenty pages are free). Checks should be made payable to Brown University.

Always include the following information in a request for medical records (so that we can find your records):

• your name;
• SIS ID #;
• complete current address and phone;
• the last year you were at Brown.

Requests ONLY for documentation of immunizations may be made by mail, or email Jennifer_Hodshon@Brown.edu

Click to print an Authorization to Exchange Medical Information by Electronic Mail