17. To participate in ethical decisions that arise in the course of your care. Members of the ethics committee
are on-call 24 hours/day.
18. To voice your concerns about the care you receive. If you have a problem or complaint, you may talk
with your health care team to resolve the problem. If unresolved, you have the following contact options:
a. UAB Hospital/Highlands and Ambulatory/HSF Clinics:
i. Contact Guest Services to request assistance from a Patient Advocate by dialing *55 from an in-
house phone or (205) 934-CARE (2273).
ii. Send a written letter of unresolved grievance to:
UAB Hospital/Ambulatory Clinics,
Chief Operating Officer
Suite 502, 500 22nd Street South
Birmingham, AL 35233
b. Callahan Eye Hospital: President, 1720 University Boulevard, Birmingham, AL 35233
or calling 325-8678.
c. File a complaint with:
• The Alabama Department of Public Health, Division of Health Care Facilities, Complaint Unit,
P. O. Box 303017, Montgomery, Alabama 36130-3017 (Complaint Unit phone number is
1-800-356-9596).
• The Joint Commission (TJC) by calling 1-800-994-6610.
• The Center for Medicare & Medicaid Services (CMS) by calling 1-800-633-4227
or cms.gov/center/ombudsman.asp.
Patient RESPONSIBILITIES:
1. You are expected to provide complete and accurate information, including your full name, address,
home telephone number, date of birth, Social Security number, insurance carrier and employer, when it
is required.
2. You should provide the healthcare facility or your doctor/dentist with a copy of your advance directive if
you have one.
3. You are expected to provide complete and accurate information about your health and medical
history, including present condition, past illnesses, hospital stays, medicines, vitamins, herbal products,
and any other matters that pertain to your health, including perceived safety risks.
4. You are expected to ask questions when you do not understand information or instructions. If you
believe you can’t follow through with your treatment plan, you are responsible for telling your doctor /
dentist. You are responsible for outcomes if you do not follow the care, treatment and services plan.
5. You are expected to actively participate in your pain management plan and to keep your doctors/
dentist and nurses informed of the effectiveness of your treatment.
6. Please leave valuables at home and only bring necessary items.
7. You are expected to treat all staff, other patients and visitors with courtesy and respect; abide by all
UAB rules and safety regulations; and be mindful of noise levels, privacy and number of visitors.
8. You are expected to provide complete and accurate information about your health insurance coverage
and to pay your bills in a timely manner.
9. You are expected to keep appointments, be on time for appointments, or to call your health care
provider if you cannot keep your appointments.
* This information is available for the sight impaired and in Spanish.
uabmedicine.org
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