611 Veterans Parkway
Woodruff, WI 54568
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Patient Rights and Responsibilities


Decision Making

You or your representative have the right to:

  • Be informed before care is given or discontinued whenever possible.
  • Receive accurate and current information regarding your health status in terms you can understand, allowing you to make informed decisions.
  • Participate in planning for your treatment, care and discharge recommendations. Surrogate whom you may select can represent you if you cannot make your own decisions according to state law.
  • Receive an explanation of proposed procedure or treatment; including risks, serious side effects and treatment alternatives, including request for second opinion or specific treatment.
  • Participate in managing your pain effectively.
  • Refuse or discontinue a treatment to the extent permitted by law and to be informed of the consequences of such refusal.
  • Receive emergency care and transfer to higher level of care (hospital) should this be necessary, providing full explanation of the need based on your medical condition & without needing to wait for authorization and without any financial penalty.
  • Have persons of your choice promptly notified of hospital admission.
  • Write a Living Will, Medical Power of Attorney, and/or a CPR Directive.
  • Accept, refuse or withdraw from clinical research.
  • Choose or change your healthcare provider.

Quality of Care

You have the right to:

  • Respectful treatment, which recognizes and maintains your dignity and personal values without discrimination.
  • Accurate information about facility where services are received and credentials of health care personnel involved in your care.
  • Interpreters and/or special equipment to assist language needs.
  • Information about continuing healthcare requirements following discharge, including how to access care after hours.

Confidentiality and Privacy

You have the right to:

  • Personal privacy and care in a safe setting free from abuse, harassment, discrimination or reprisal.
  • Personal information being shared only with those who are involved in your care.
  • Confidentiality of your medical and billing records.

Grievance Process

You or your representative have the right to:

  • Fair, fast and objective review of any complaint you have against your health plan, physician or healthcare personnel without fear of reprisal.
  • Submit a formal complaint either verbally or in writing as shown below. You will receive a written notice of decision within 15 business days from when the complaint was made known.

Access to Medical Records

You have the right to:

  • Speak privately with health care providers knowing your health care information is secure.
  • Review and receive a copy of your medical records (including electronic format) upon written request and received within 30 days by secure transmission.

Seclusion and Restraints

You have the right to:

  • Be free from seclusion or restraint for behavioral management unless medically necessary to protect your physical safety or the safety of others.


You have the right to:

  • Information specific to fees for services and payment policies prior to date of services.
  • Payment privacy when you choose to opt out of insurance coverage for services.

Advance Directives

You need to be aware that Northwoods Surgery Center does not honor Advance Directives.

  • You are able to provide a copy of your Advance Directives for your chart in the event you are transferred to the hospital.
  • Upon request a valid Advance Directive Form approved by the State of Wisconsin will be provided for you.
  • Information regarding Advance Directives can be obtained from the Wisconsin Department of Health Services at


Providing Information

 You have the responsibility to:

  • Provide accurate and complete information about present complaints, past illnesses, hospitalizations, current use of prescribed or OTC medications, nutritional supplemental products and other health-related matters.
  • Report perceived risks in your care and unexpected changes in your condition.
  • Provide an Advance Directive if you have one.
  • Provide accurate and updated demographic and contact information for insurance and billing.


You have the responsibility to:

  • Participate in your plan of care and follow the recommended treatment plan.
  • Ensure you have a designated responsible adult to provide transportation and assist with your care for 24 hours.

Respect and Consideration

You have the responsibility to:

  • Act in a respectful and considerate manner toward healthcare providers, other patients, and visitors. Physical or verbal threats or conduct which is disruptive to business operations will not be tolerated.
  • Be respectful of the possessions or property of others.
  • Be mindful of noise levels.

Insurance Billing

You have the responsibility to:

  • Know the extent of your insurance coverage.
  • Know your insurance requirements such as pre-authorization, deductibles and co-payments.
  • Call the billing office with questions or concerns regarding your bill.
  • Fulfill your financial obligations as promptly as possible.
  • Contact our Business Office at 715.358.8600 if you have any questions or concerns.

 Your physician may have a financial interest in the Northwoods Surgery Center. Northwoods Surgery Center is a joint venture with Aspirus Wausau Hospital, Mark Balas, M.D. and Michel Gelinas, M.D.