1Client Information

2Your Rights as a BridgeCare Client

As a client of BridgeCare Home Services LLC and BridgeCare Transportation LLC, you have the following rights:

• Be treated with dignity, respect, and courtesy at all times.
• Receive care without discrimination based on race, color, national origin, sex, age, disability, or religion.
• Be informed of all services available and their associated costs.
• Participate in developing and updating my care plan.
• Refuse services or treatment and be informed of the consequences.
• Have my personal and medical information kept confidential.
• Be free from abuse, neglect, exploitation, and mistreatment.
• Voice complaints and grievances without fear of retaliation.
• Receive a written notice of any changes to services at least 10 days in advance.
• Have access to my records and request corrections.
• Be informed of my rights in a language I understand.

3Your Responsibilities as a BridgeCare Client

As a client, you also have the following responsibilities:

• Provide accurate and complete information about my health and needs.
• Notify BridgeCare of any changes in my condition or circumstances.
• Treat BridgeCare staff with respect and courtesy.
• Follow the agreed-upon care plan and notify staff of any concerns.
• Be present or have a responsible adult present during scheduled care visits.
• Provide a safe environment for BridgeCare staff.
• Notify BridgeCare at least 24 hours in advance if I need to cancel a scheduled visit.

4Guardian / Legal Representative (if applicable)

Complete this section only if signing on behalf of the client.

5Acknowledgement & Signature