• Patient Partnership Plan

    Share your partnership plan details and provide your signature and date.
  • Patient Partnership Plan



    Our Commitment to You:


    1. We will provide you with complete information about your diagnosis and treatment options.
    2. We will listen to your concerns and answer your questions honestly and respectfully.
    3. We will involve you in decisions about your care and respect your choices.
    4. We will maintain your privacy and confidentiality at all times.


    Your Commitment to Us:


    1. You will communicate openly and honestly with your healthcare team.
    2. You will follow the agreed-upon treatment plan and ask questions if you do not understand any part of it.
    3. You will notify us promptly of any changes in your condition or concerns about your care.
    4. You will respect the rights and privacy of others in the healthcare setting.
  • Date*
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