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ALLIED HEATH PROFESSIONAL STATEMENT OF SPONSORING/SUPERVISING PHYSICIAN I hereby request that , who is applying for permission to provide patient care services as a be granted permission to provide.

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Making health care easier, so life can be better.

Our Mission As a nonprofit, Banner Health exists to provide health care services to the communities we serve, rather than generate profits. That means that every dollar we earn is reinvested into: New hospital beds. New or expanding patient care services.

A patient has the following rights: 1. Not to be discriminated against based on race, national origin, religion, gender, sexual orientation, age, disability, marital status, or diagnosis; 2. To receive treatment that supports and respects the patient's individuality, choices, strengths, and abilities; 3.

Summary of LPS Patients' Rights Treatment should be provided in ways that are least restrictive of the personal liberty of the individual. A right to dignity, privacy, and humane care. A right to be free from harm, including unnecessary or excessive physical restraint, isolation, medication, abuse, or neglect.

You have the right to: Receive considerate and respectful care within the scope of our mission that recognizes your personal dignity, values and beliefs. Wear appropriate personal clothing and religious or other symbolic items, as long as they do not interfere with diagnostic procedures or treatment.

Right to Be Treated With Respect. Right to Emergency Care. Right to Obtain Your Medical Records. Right to Privacy of Your Medical Records. Right to Informed Consent. Right to Refuse Treatment. Right to Refuse to Take Part in Research. Right to Receive and Question Itemized Bills for Medical Services.

BUSINESS AND BUSINESS CASUAL ATTIRE IS ACCEPTABLE YOU ARE EXPECTED TO CHANGE INTO HOSPITAL ISSUED SCRUBS AND TO CHANGE BACK INTO YOUR CLOTHS WHEN THE PROCEDURE IS COMPLETED. YOU MAY NOT WEAR HOSPITAL ISSUED SCRUBS BETWEEN BANNER FACILITIES.

As a patient, you have the right to: Receive complete and current information concerning your diagnosis, treatment, and prognosis in terms you can be reasonably expected to understand. Request a second opinion from another physician. Participate actively in determining a course of treatment for yourself.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232