You and your family are our number one concern during your visit to Heritage Medical Associates. The following statement of your rights and responsibilities is presented as the policy of this facility, but does not presume to be a complete representation of all-mutual rights and responsibilities.

You have the right to:
  • Receive considerate, respectful care, which recognizes your personal dignity at all times and under all circumstances.
  • Participate in decisions involving your care. Except in an emergency situation, you shall not be subjected to any procedure without your voluntary, competent and understanding consent or the consent of your legally authorized representative.
  • Refuse treatment to the extent permitted by law and to be informed of the consequences of that refusal.
  • Information about Advance Directives, such as Living Will or Durable Power of Attorney for Health Care, that would allow you to make your own health care decisions for the future and to have your chosen representative exercise these rights for you if you are not able to do so.
    Instructional and educational information about your medical treatment in a language and terms that you understand.
  • The confidential treatment of and personal access to your medical record.
  • Know who is responsible for providing your direct care and to receive information concerning your continuing health care needs and alternative for meeting those needs.

You have the responsibility to:
  • Give your doctor and Heritage Medical Associates staff complete and accurate information about your condition and care.
  • Follow instructions of your doctor and the staff of Heritage Medical Associates and to keep appointments relative to your care.
  • Make it known whether you clearly understand planned actions and treatment and what is expected of you.
  • Report unexpected changes in your condition to your physician or staff of Heritage Medical Associates.
  • Accept the financial obligations associated with your care.
  • Advise your doctor or any office staff member of any dissatisfaction your may have regarding your care.
  • Be considerate of other patients and of staff members who are caring for you.
  • Bring a current copy of any Advance Directives at the time of the first visit to be placed in your medical record.

Heritage Medical Associates (HMA) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, spiritual or ethical beliefs or source of payment. HMA:

  • Provides free aids and services to people with disabilities to communicate effectively with us.
  • Provides free language services to people whose primary language is not English.
    • If you speak English, language assistance services, free of charge, are available to you. Call 1-800-945-7889.
    • Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-945-7889.
    • ملحوظة:  إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان.  اتصل برق -1-800-945-7889.
    • 如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-800-945-7889.
    • Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-945-7889.
    • 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-800-945-7889 번으로 전화해 주십시오.
    • Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-945-7889.
    • ໂປດ​ຊາບ: ຖ້າ​ວ່າ ທ່ານ​ເວົ້າ​ພາ​ສາ ລາວ, ການ​ບໍ​ລິ​ການ​ຊ່ວຍ​ເຫຼືອ​ດ້ານ​ພາ​ສາ, ໂດຍບໍ່​ເສັຽ​ຄ່າ, ແມ່ນມີ​ພ້ອມໃຫ້​ທ່ານ. ໂທ​ຣ 1-800-945-7889.
    • የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-800-945-7889.
    • Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-945-7889.
    • સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-800-945-7889.
    • 日本語を話される場合、無料の言語支援をご利用いただけます。1-800-945-7889 まで、お電話にてご連絡ください。
    • Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-800-945-7889.
    • यद आप हदी बोलते ह तो आपके िलए मुफ्त म भाषा सहायता सेवाएं उपलब्ध ह। 1-800-945-7889 पर कॉल कर
    • Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-945-7889.
    • توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با - 1-800-945-7889 تماس بگیرید

If you need these services, contact Dawn Chrismer at her information listed below.

If you believe that HMA has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

Dawn Chrismer, RHIT, CHC, CCS-P | Director of Business Services / Compliance Officer
222 22nd Avenue North | Suite 100 | Nashville, TN 37203
P: 629-255-3333 | F: 629-255-3075 | E:

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. File electronically through the links below, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Office for Civil Rights Complaint Portal

Online Complaint Forms