If you want another family member to have access, you must complete a release form which can be found here.

If you would like to know more about our privacy policy, click here for English and here for Spanish. If you need help in another language, please let our Front Desk Staff know.

Rights and Responsibilities

Fair Haven Community Health Care believes that every patient in our care should be treated with dignity, respect and compassion. We recognize that all patients have basic rights, and we are committed to honoring these rights. As a trusted member of your care team, we also recognize that responsibilities for good health are shared between providers and patients.

Please take a few moments to familiarize yourself with ways listed below that will help make your health care experience the best it can be.

As a patient of Fair Haven Community Health Care, you are protected by the practices listed below.

Please click on the appropriate link below for a downloadable copy, which is also readable on screen.

• Nondiscrimination Statement / Declaracion de No Discriminacion
• Compliance and Ethics Program
• Language Help

If you have a question or concern, you can reach out thru confidential communication to:

• Director of Risk Management & Safety: Kevin Stranahan (203) 777-7411, x5744 or k.stranahan@fhchc.org
• For anonymous reporting, you may call Fair Haven’s Corporate Compliance Hotline at 203-974-0123.

Your Rights
As a patient of Fair Haven Community Health Care, you have the right to:

Access to Care

• Access care that is available or medically indicated regardless of race, creed, gender, national origin, cultural or spiritual values, disability, sexual orientation or ability to pay. This includes all scheduled and walk-in patients.
• Obtain, from the providers responsible for coordinating and providing your care, complete and current information about outcomes of care, diagnosis (to the degree known), treatment, alternatives, risks or unanticipated outcomes of care and any known prognosis, so that you can participate in decisions about your care.
• Be involved in making decisions about your care and services, and to include a family member or partner in decision-making about your care, treatment or service decisions to the extent permitted by law and regulations.
• Choose your medical provider, and to know the name and position of the provider(s) who are responsible for your care, treatment or services.
• You have the right to obtain care from other clinicians within the primary care medical home, to seek a second opinion, and to seek specialty care.

Communication

• Be given information in terms you can understand. When it is not medically advisable to give you such information, it should be made available to your legal representative.
• Have an interpreter if you don’t speak English or are hearing impaired. Accommodations can be made for patients with hearing, speech, visual and cognitive impairments by requesting these services at the time the appointment is made.

Consent

• Receive the necessary information to participate in decisions about your care and to give your informed consent before any treatment or procedure is performed.

Security

• Be free from all forms of abuse or harassment and have access to protective and advocacy services.

Safety

• Have care provided in a safe setting. Everyone has a role in making health care safe, including providers, healthcare executives, nurses and technicians. You play a vital role in making your care safe by becoming an active, involved and informed member of your healthcare team. Please make your health care providers aware of any concerns you have.

Pain

• Tell someone about your pain is and to have a care plan for how to address your pain.

Privacy

• Expect that your personal privacy, within the law, will be respected and maintained by all staff as demonstrated by the following rights: To be interviewed and examined in surroundings designed to assure reasonable visual and auditory privacy; to request to have another person present during certain parts of a physical examination, treatment or procedure performed by a health professional of any sex; and to expect that any discussion or consultation involving your care will be conducted discreetly.

Refusing treatment

• Refuse treatment to the extent permitted by law. When refusal of treatment by you or your legal representative prevents the provision of appropriate care in accordance with professional standards, our relationship with you may be terminated upon reasonable notice.

Medical Records

• Expect that your medical records will be kept confidential and will be released only with your written consent, in cases of medical emergencies, or in response to court-ordered subpoenas. Confidentiality can also be violated if the individual poses a significant threat or harm to self or others.
• Access, request amendment to, and obtain information on disclosures of your health information, in accordance with law and regulations.

Charges

• Receive a copy of a reasonably clear and understandable itemized bill and have the charges explained upon request even if they are covered by insurance.

Advance directives

• Receive information about advance directives. Advance directives ensure that your wishes, in written or oral form, are carried out.

Your Responsibilities
As a patient of Fair Haven Community Health Center, you are an integral part of the healthcare team. Therefore, you are responsible for:

Education
Participating in the teaching/learning process so that you will acquire and understand the skills and behaviors that promote recovery, maintain or improve function, or manage disease or symptom progression.

Appointments
Keeping appointments and for notifying Fair Haven Community Center when you are unable to do so.

Compliance
Following the treatment plan recommended by the practitioner primarily responsible for your care.

Information
Providing accurate information about your past medical, mental health, and social history including informing us about any other healthcare provider (s) currently participating in your care.

Communication
Asking questions if you do not understand the explanation of your diagnosis, treatment, prognosis, or any instructions.

Medical Record
Providing the necessary personal information to complete your file, including but not limited to address changes, household information or financial status.

Rules and Regulations
Following any rules and regulations that are posted for your safety.

Personal Responsibility
Not engaging in verbal or physical threats to self and others and not bringing weapons to the Center.

Charges
You are responsible for paying any charges billed to you, or for making other arrangements with our staff.

Partnership
Becoming a partner in your healthcare by complying with medical treatment and instructions.

Respect and consideration
Being considerate of the rights of other patients and Center staff. This includes not smoking in any form and controlling noise. You are responsible for being respectful of the property of the Center. You understand that any abusive or disrespectful behavior could result in your dismissal from the Center.

Your Concerns
If you have a concern about any aspect of your care at Fair Haven Community Health Care, you are urged to let us know so we can resolve it promptly. This reporting will in no way negatively impact future care. To address concerns, please contact the administrator or nurse manager on call. Please ask a patient representative to connect you with any of these individuals.

If you would like to make a complaint to Fair Haven Community Health Care, state or an outside agency, you may contact the following:

Manan Dave, Chief Corporate Compliance Officer
Fair Haven Community Health Care
(203) 777-7411, x5113 or privacyofficer@fhchc.org

Joint Commission
One Renaissance Blvd.
Oakbrook Terrace, IL 60181
(800) 994-6610

Connecticut Department of Insurance
(800) 203-3447

Agency for Health Care Administration
Consumer Services Unit
(888) 419-3455

You can download a copy here in Spanish or here in English.

Join Our Family—Schedule an Appointment Today

We’re here to support your child’s health and well-being at every stage.Schedule an appointment online through MyChart or call us at 203-777-7411. We look forward to partnering with your family on the journey to health and happiness!

Fair Haven Community Health Care is here to provide care you can trust. We focus on helping you and your family feel welcome, understood, and supported at every step. Here are three reasons why patients choose us: