We believe healthcare is a partnership between provider and patient. In that spirit of cooperation, we would like to present your rights and responsibilities.

Patients’ Rights
  1. Look at or get copies of your medical information. You may request that we provide copies in a format other than photocopies. You must make your request in writing. You may get the form to request access by asking one of our front desk staff. If you request copies of your medical records please allow up to fifteen (15) days.
  2. You have the right to review your records. You must coordinate a time with our front office staff to do so.
  3. Receive a list of all the times we or our business associates shared your medical information for purposes other than treatment. Payment and health care operations and other specified exceptions.
  4. If you request that we place additional restrictions on our use or disclosure of your medical information, we are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in the case of an emergency).
  5. Request that we communicate with you about your medical information by different means or to different locations. Your request that we communicate your medical information to you by different means or at different locations must be made in writing to our office.
  6. Request that we change your medical information. We may deny your request if we did not create the information you want changed or for certain other reasons. If we deny your request, we will provide you with a written explanation. You may respond with a statement of disagreement that will be added to the information you wanted changed. If we accept your request to change the information, we will make reasonable efforts to tell others, including people you name, of the change and to include the changes on any future sharing of that information.
  7. If you have received this notice electronically, and wish to receive a paper copy, you have the right to obtain a paper copy by making a request in writing to the Privacy officer at our office.
Patients’ Responsibilities
  1. Keep regular ,follow up appointment as advised by Dr. Green. We cannot be responsible for your care without your consistency. Telephone appointments may be arranged for some for your visits if you live out of the area. This must be approved by Dr. Green.
  2. Appointment confirmations will be made by email using OpenMedNet to the email address you have provided. Please acknowledge your appointment when this notification is received. Only patients who do not have an email address on file with us will receive confirmation telephone calls. By providing us with an email address for notification and use of the Patient Portal, it is the patient’s responsibility to acknowledge and keep scheduled appointments.
  3. Time is limited during your office visit. You are required to have a Primary Care Provider who treats your basic medical needs and emergencies.
  4. Missed follow up appointments will result in the full charge of the scheduled appointment, if the appointment is not cancelled or rescheduled at least 3 business days before the original appointment time. This fee cannot be waived. For new patients, you must cancel or reschedule your visit at least 10 business days before your currently scheduled appointment. Cancellations less than 10 business days ahead can be rescheduled but are not refunded.
  5. Please come organized to appointments with a written list of concerns. Come prepared to take your own notes during the visit. A patient instruction plan will be provided after appointments as a courtesy but the patient is responsible for also taking notes regarding continuing care.
  6. Communication with Dr. Green and her staff can be accomplished in 2 ways: Through the secure patient portal through OpenMedNet or by telephone. Please see the administrative staff at the office in which you are seen for instructions on enrolling in the OpenMedNet Patient Portal. This is a secure , HIPAA compliant manner in which to communicate. Phone messages will be answered each business day and in the order of medical necessity. Please call the office at which you are seen with messages. Try to keep your telephone messages brief and to the point and call one time regarding your message. Any request that requires an in-person pick up must be scheduled 24 hours in advance. NO DROP INS PLEASE.
  7. Lab results and other requested documents can be obtained by the patient in 2 ways:
    Patients can access laboratory results, patient instructions and handouts by using the patient portal through OpenMedNet. Please see the administrative staff at the office at which you are seen for instructions how to enroll in the secure Patient Portal through OpenMedNet. An email address is required for this process. If the patient does not use the portal system, lab results and other requested documents will be given to the patient at the time of an office visit or sent through the US Mail only, not by email or fax.
  8. Please fax to either the Mountain View office at 650-523-4682 or the San Francisco office at: 415-992-5917, if you need a letter written on your behalf. Go to the Patient Portal or to Patient Forms Section to obtain the necessary Letter Request Form.
  9. Please fax to either the Mountain View office at 650-523-4682 or the San Francisco office at: 415-992-5917, if you need records sent to you or another Health Care Provider on your behalf. Go to the Patient Portal or to Patient Forms Section to obtain the necessary Records Release Form.
  10. Telephone inquires will be answered as soon as possible and in the order of medical necessity. If you have an URGENT OR EMERGENT MEDICAL PROBLEM, please go to your nearest emergency room or primary care provider. Most treatment changes are complicated and cannot be managed over the phone. If a treatment change is necessary, it will usually require an office visit.
  11. If you need prescriptions refilled, please contact your pharmacy and ask them to fax a refill request to the office in which you are seen. Please allow 5 business days for refill requests, but we will return those requests to the pharmacy as soon as possible. If prior authorization is needed for a medication, those requests will be handled by our staff in the order in which they are received. Your pharmacy must forward us a denial and request prior authorization when a medication is denied or is pending Prior Authorization. You will be notified of decisions received by our office regarding your Prior Authorization status.
  12. If prior authorizations are needed for tests or procedures, patients must contact the insurance company and request that they fax us a prior authorization form(s) for the medication(s) or tests needed.
  13. Your office visit is for YOUR care only. We cannot discuss a family member’s or friend’s symptoms or treatments during your visit. If other individuals need medical care, they will need to make a separate appointment.
  14. Former patients who have not been seen by the doctor in 2 or more years will be considered a new patient and will need to schedule a new patient visit.