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Behavioral Health Choices Patient Bill of Rights 1. You have a right to be treated with dignity and respect. 2. You have the right to not be discriminated against on the basis of race, age, sex, religion,

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How to fill out you have a right

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Step 1: Obtain a copy of the 'You Have a Right' form.

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Step 2: Read the instructions carefully to understand the purpose and requirements of the form.

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Step 3: Fill in your personal information, such as your name, address, and contact details, in the designated fields.

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Step 4: Provide accurate and up-to-date information about the incident or situation that prompted you to assert your rights.

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Step 5: Clearly state the specific rights you believe have been violated and provide any supporting evidence or documentation.

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Step 6: Review the completed form for any errors or omissions.

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Step 7: Sign and date the form to attest to the accuracy of the information provided.

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Step 8: Submit the filled-out form to the appropriate authority or organization as indicated in the instructions.

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Anyone who believes their rights have been violated and wishes to assert and document their rights.

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Advocacy groups, non-profit organizations, or legal entities supporting individuals in asserting their rights.

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What is you have a right?

You have the right to access and control the information we collect about you.

Who is required to file you have a right?

Any individual whose personal information is being collected or processed.

How to fill out you have a right?

You can fill out a request form or contact the organization collecting your information.

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The purpose is to give individuals control over their personal data and how it is used.

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The type of information being collected, how it is used, and who it is shared with.

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