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Phone - (916) 569 8585    Fax - (916) 640 0100
We Offer
  • Child Care
  • Routine Physical Examination
  • Female Gyn/Family Plan (Inc.Contraception)
  • Hospitalization
  • Minor Surgery
  • Immunization
  • Nursing Home Care
  • Drug Addiction/Dependence [Suboxone Therapy]
  • Other Facilities (After Hr Ph Calls, Weekend Coverage)
Forms
Patient Registration Form
Suboxone Therapy Contract Form
Associations

Mercy General Hospital www.mercygeneral.org

Mercy Folsom
www.mercyfolsom.org
Clinic Policy
MISSED APPOINTMENTS- If three (3) appointments are missed without contacting our office prior to the appointment time, we can no longer provide medical care to you and you may be discharged from our practice.

LATE ARRIVAL- If you arrive 15 minutes past your scheduled time, your appointment will be rescheduled.

PAPERWORK- Allow 7-10 business days for completion of any paperwork. A charge of $10-15 per form is due BEFORE the paperwork is completed. Please let us know if you plan to pick up the forms or you would like us to mail them.

REFILLS- Please allow 24-48 business hours for refills to be called in to the pharmacy. Check with the pharmacy first before calling the office back.

INSURANCE/PRIOR AUTHORIZATION- You are responsible for checking with your insurance company for scheduled procedures (MRI, CT scan, referrals, etc.) Make sure if prior authorization is needed, it is obtained BEFORE the procedure is performed.

FOLLOW UP APPOINTMENTS- All lab and test results will be discussed at your follow-up appointment. We will call you with any urgent results.

ANSWERING SERVICE- Our afterhour’s answering service is available for emergencies ONLY. Do not call with refill requests, lost medications, etc. If you do not receive a return call from the on-call physician within 30 minutes, please go to the emergency room/nearest urgent care if you believe it needs to be emergently addressed.

NARCOTICS AND CONTROLLED SUBSTANCES- All narcotic medications or controlled substances are prescribed at the physician’s discretion. You are required to sign a controlled substances contract and may be subject to random drug screening.

FINANCIAL LIABILITY- Patients are ultimately responsible for the total payment of a procedure, test or visit, if not completely covered by their insurance.

PATIENT’S RIGHTS: As a patient, you have the right to:
• Participate in the development and implementation of your plan of care.
• Accept or refuse medical care to the extent of the law and to change your mind regarding your care at any point.
• Formulate advanced directives.
• Have clinical records and personal information kept in the strictest confidence in accordance with the law.
• Receive care in a setting which is safe, physically and emotionally.
• Receive care in a manner which is courteous and respectful of personal values and beliefs.
• Receive access to medical care and to your medical records.
• Request and receive a detailed explanation of your bill.

PATIENT’S RESPONSIBILITIES: As a patient, you have the responsibility to:
• Provide accurate and complete health information.
• Understand and follow the agreed-upon plan of care.
• Accept responsibility for the outcomes of refusing treatment or not following the agreed-upon plan of care.
• Fulfill your financial obligations.
• Be considerate and respectful of other patients, staff and their property.
 
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