Release of Information

Our provider-patient relationships are based on mutual expectations. Patients have the right to be treated with respect and ensure their information is kept confidential. Jordan Valley asks that patients take responsibility for certain actions regarding their care. Please review these rights and responsibilities before you begin your journey with Jordan Valley.

Patient Rights

As a patient of Jordan Valley Community Health Center, you have the right to:

  1. Be treated with respect, dignity, and compassion.
  2. Get care which is free of discrimination on the basis of age, sex, race, faith, religion, marital status, national origin, disability, genetic information, color, gender identity, sexual orientation, public assistance status or criminal record, or any other protected class.
  3. Get care based on your own needs. Jordan Valley makes language interpretation services available at no cost to you. Jordan Valley will respect your cultural and spiritual beliefs and your personal values as long as those practices do not harm others or interfere with good medical care.
  4. Have your privacy protected at all levels of care, including check-in and in evaluation and treatment areas. Jordan Valley must assure the privacy and security of your records and can share information about you only with your permission, when medically necessary, or as otherwise permitted
    by law.
  5. Have access to your own health records.
  6. Be given the names of the doctors providing your care and the names and titles of other healthcare persons who assist you.
  7. Be given information about your diagnosis, prognosis, and recommended treatment in ways that you can understand so you can make informed decisions about your care. That information will include possible outcomes or risks of treatment. If it’s not possible to share this information with
    you because of your health condition, Jordan Valley will share with your appropriate family member or legal representative.
  8. Continuity of care within the laws and policies that apply to the clinic and within resources available.
  9. Get skilled and timely care.
  10. Expect prompt and appropriate treatment in emergency situations.
  11. Get helpful transfer and transport to another healthcare facility when medically necessary.
  12. Information about how to get after hours or emergency care.
  13. Refuse a medication, treatment, or procedure and be informed of the possible health consequences of your refusal.
  14. Tell us your complaints by talking to us or writing us and get a response from Jordan Valley.
  15. Have an Advanced Care Plan that’s followed by your care team.
  16. Choose whether to participate in any investigative procedure or medical care research program.
  17. Get a consult with or change your doctor, dentist, or other health care provider.
  18. Be told of all fees for your care and how to pay those fees.
  19. Get information about relationships Jordan Valley or your doctor has with other health care professionals or facilities as far as your care is concerned.
Patient Responsibilities

As a patient of Jordan Valley Community Health Center, you have the responsibility to:

  1. Give Jordan Valley truthful and complete information about your current health complaint, past medical history, and other information about your health.
  2. Tell us whether you understand your diagnosis, treatment plan, medicines, and what’s expected of you. Ask questions when you don’t understand.
  3. Follow the treatment plan set by your healthcare team and participate in your care.
  4. Schedule and keep your appointments and let us know when you can’t keep an appointment.
  5. Own your actions if you choose not to follow your treatment plan or the advice of your healthcare team.
  6. Follow Jordan Valley’s procedures for preventing or stopping the spread of infections, such as answering screening questions, wearing a mask, or social distancing.
  7. Pay the fees for your care as agreed with Jordan Valley.
  8. Follow Jordan Valley’s policies and procedures.
  9. Treat other patients and staff of Jordan Valley respectfully.
  10. Respect the property and facilities of Jordan Valley.
  11. Arrange appropriate transportation and support at home after procedures requiring sedation or anesthesia or as indicated on your discharge instructions.
Reporting Concerns

Let’s resolve your concerns as soon as possible. If you feel Jordan Valley hasn’t respected your rights or has not followed the expectations of this notice, please contact your Jordan Valley Clinic and speak with a manager so we can address your concerns.

You can also report concerns or complaints to Jordan Valley by one of the following methods:

  1. To complete an electronic feedback form [click here]
  2. By mail: Jordan Valley Compliance Officer PO Box Springfield, MO 65801
  3. By email: [email protected]
  4. By hotline: 417-851-1556 (anonymous reporting available)

Complaints can also be filed with:

Missouri Department of Health and Senior Services
Bureau of Health Services Regulation
PO Box 570
Jefferson City, MO 65102
[email protected]

You can reach the Office of Civil Rights at (800) 368-1019.