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Woods & Water Medical Center

1019 South Knowles Avenue


New Richmond, WI 54017
(715) 246-6561
www.WWMC.com

Patient Rights
Woods & Water Medical Center wants every patient to receive the best possible care. To that end, want you to know what your
rights are. For example, it is your right to receive care without discrimination, have your family involved, participate in planning your
medical treatment, complete an advance directive outlining your healthcare wishes and have your healthcare kept confidential.
Specific rights listed below.

As a patient at Woods & Water Medical Center I, or my authorized representative, have the right to:

• Receive care without discrimination due to my race, management or are imposed as a means of coercion,
creed, color, national origin, ancestry, religion, sex, discipline, convenience, or retaliation by staff.
sexual orientation, marital status, age, newborn • Receive evaluation and provision of protective
status, handicap, or source of payment. services.
• Have my family and physician notified promptly of • Designate who is permitted to visit me during my
my admission and have my family participate in my hospitalization.
care decisions. • Receive care and treatment that respects my values,
• Know the name of the physician or other beliefs, and life philosophy.
practitioner who has primary responsibility for my • Address ethical questions that arise in my
care and know the identity and professional status of healthcare.
the people caring for me. • Receive emotional and spiritual support for my
• Receive from my physician, in terms I can family and me.
understand, current information about my diagnosis, • Complete an advance directive outlining my wishes
treatment, and prognosis. regarding my healthcare should I become unable to
• Receive from my physician, except in emergencies, express my wishes. This may include my wishes
Information that allows me to give informed consent regarding organ and tissue donation.
before beginning any procedure or treatment. • Refuse treatment to the extent permitted by law and
• Participate in the planning of my medical treatment be informed of the medical consequences of my
and to decline to participate in experimental actions.
research. • Be informed of the need for, alternative to, and
• Receive care for symptoms that will respond to acceptance by another facility when transfer to the
treatment, even if they are not related to my facility is planned.
primary healthcare condition. • Have all communications and records pertaining to
• Receive evaluation and management of pain. my healthcare kept confidential.
• Receive considerate and respectful care in a safe and • Have access to my medical record within a
private environment free of neglect, harassment, reasonable timeframe.
and abuse. • Examine and receive an explanation of my bill
• Be free from restraints of any form that are not regardless of the source of payment and receive
medically necessary or are used as a means of information regarding financial assistance.
coercion, discipline, convenience, or retaliation by • Receive information regarding the relationship of
staff. Woods & Water Medical Center to other healthcare
• Be free from seclusion and restraints of any form or educational institutions involved in my care.
that are not necessary for emergency behavior • Receive complete language translation, free of
charge.

I have read and understand my rights.

Patient Signature Date

4/17/21

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