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Nubh Individual Rights

    SUMMARY OF INDIVIDUAL RIGHTS IN COMMUNITY MENTAL HEALTH AND SUBSTANCE ABUSE

    (Provide Client Copy)


    When you receive services in a community mental health, mental retardation, and/or substance abuse program,
    your rights are protected by Rules and Regulations contained in Chapter 290-4-9.
    A full copy of the Rules is available to you at the program where you are served.
    Below is a simplified outline of those rights. The Rules and Regulations describe any limitation to these
    rights and other provisions which may apply and should be consulted when there is a dispute or question regarding any of these rights.

    Your Rights Include:

    • The right to an interpreter if you do not speak English or are hearing impaired.

    • The right to receive services that respect your dignity, and protect your health and safety.

    • The right to know the names and positions of all those involved in the services planning and implementation process.

    • The right to be informed of the benefits and risks of your treatment.

    • The right to participate in planning your own program.

    • The right to refuse service, unless a physician or licensed psychologist feels that refusal would be unsafe for you or others.

    • The right to receive care suited to your needs.

    • The right to prompt and confidential services even if you are unable to pay.

    • The right to review and obtain copies of your records, unless the physician or authorized staff feels it is not in your best interest.

    • The right to exercise all civil, political, personal and property rights to which you are entitled as a citizen.

    • The right to be free of physical or verbal abuse.

    • The right to converse privately, to have reasonable access to a telephone, to receive/send mail, to have visitors and to retain your personal effects, clothing, and money — except if denial is necessary for treatment or rehabilitation, documented by a physician or licensed psychologist.

    • The right to have advance directives, such as a living will, health care proxy, or durable power of attorney that clearly states your treatment wishes.

    • The right to file a complaint if you think any of these rights have been restricted or denied.


    If you want to know more about your rights, a full copy of the Regulations is available to you on report.
    A summary of the Individual Rights Complaint Process is also available.

    Consent Acknowledgment


    The Individual/Legal Representative has had an opportunity to read, or have read to him/her, the above form
    and ask questions regarding the data contained therein and has done so in this staff member’s presence.

    Signature