• Your insurance card
• Photo identification
• Co-payment
• Your medications
• Diabetic log if you are diabetic
• Please also bring information about your medical history, and a list of doctors or hospitals that you have visited and discharge summaries from recent hospital or specialist visits.
• For children, please bring their immunization records to their first visit to the health center.
• Parents must accompany all minors (children under age 18) to appointments.

• Please call Esperanza Health Center at least two full business days before the referral is needed and select the option to leave a message for your clinician.
• Leave your name, date of birth, telephone number, insurance and detailed information about the type of referral you need.
• Include the name, telephone number and fax number of the specialist you wish to be referred to, and the reason for referral.
• If the referral is not for treatment previously recommended by your Esperanza clinician, you may need to see an Esperanza clinician first.
• Same-day or one-day referrals can only be processed in cases of emergency. Without sufficient notice you may need to reschedule your specialist appointment.
• You will be notified when the referral is ready, and if you need assistance we will help you to make your appointment.
• If your referral requires prior-authorization due to insurance regulations, this may take additional time.

• If you have a scheduled appointment, your test results will be addressed with you at that time. If you have a seriously abnormal result, someone on our staff will call you.
• If you don’t have an appointment regarding test results within a reasonable time period, please call to request your results.

• If you receive your medications from Esperanza’s Medication Dispensary, please visit this page for information about refills.
• For medication refills from an outside pharmacy, please call your pharmacy to request that an electronic refill request be sent to your clinician at least three days before your medicine runs out. Your clinician will respond directly to your pharmacy.

• Please call the receptionist as early in the day as possible to schedule an appointment. Tell them you are sick and would like an appointment.
• If no appointment is available that day, a nurse will call you back to discuss your illness and determine the best course of action.
• If you come in without calling ahead first, please know you may need to wait a while before you can be seen.

What is a Patient-Centered Medical Home?

A patient-centered medical home (PCMH) is a coordinated, team approach to providing health care that is focused on you, the patient.

All three of Esperanza Health Center’s sites have been recognized as Level 3 Patient-Centered Medical Homes—the highest level of recognition—by the National Committee for Quality Assurance (NCQA). As a Patient-Centered Medical Home, we are committed to improving your health, by providing high-quality, evidence-based care, support services and the resources you need.

Who is on my Esperanza Patient-Centered Medical Home team?

As an Esperanza patient, your care team may include physicians, nurses, physician assistants, nurse practitioners, dietitians, behavioral health consultants, social workers, health educators, medication dispensary technicians, and care coordinators.

What do I need to do as part of my Patient-Centered Medical Home team?

• Keep us informed of any changes! Please let us know if your phone number, address, email, or insurance information has changed.
• Provide us with your complete medical history and let us know about care you receive from other outside health care providers.
• Please call us with any questions or to schedule an appointment, before you go to an Emergency Room or Urgent Care clinic.
• Let us know if you have been in the hospital recently, and please call us as soon as you are released from the hospital.
• Let us know of any changes in your medications after a hospital stay or from another health care provider.
• Bring all your medications (or a list of all your medications) with you to appointments.

What role does Esperanza play?

We want to ensure that you are at the center of your health care! To do this, we will:

• Help you to manage your healthcare, including chronic conditions such as diabetes.
• Listen to your concerns and answer your health questions.
• Encourage you to be actively involved in your health care and in prevention.
• Coordinate the integrated care and services that you receive both within Esperanza Health Center and from other outside providers.
• Provide equal access to all patients regardless of insurance status.
• Help you to apply for insurance coverage if you do not have it.
• Help new patients navigate getting their medical records transferred to our office.

Esperanza Patient Bill of Rights and Responsibilities

These rights can be exercised on the patient’s behalf by a designated decision maker if the patient lacks decision-making capacity, is legally incompetent, or is a minor.

You Have The Right To:

1. Be treated with dignity and respect at all times.
2. To receive services regardless of social or economic background.
3. To receive services without regard to one’s ability to pay; if you are unable to pay the full fee for services, a sliding fee scale is available to you.
4. Know the names of those treating you.
5. Receive quality services from qualified personnel.
6. Expect reasonable continuity of care when appropriate, and to be informed of available and realistic options when your provider is not able to see you.
7. Phone access to a provider via the answering service for urgent issues which occur after business hours, and cannot medically wait for the next business day.
8. Obtain relevant, current and understandable information concerning your diagnosis, treatment and prognosis.
9. Participate in treatment planning, including the right to refuse service or treatment.
10. File a complaint if you feel your rights have been violated.
11. Request that a staff person pray with you, or refuse prayer if you do not want it.
12. EHC will keep your personal health information confidential. Medical staff responsible for treatment, payment or operations will have access to these records. Personal health information requested for other purposes will require your written consent, except as required by law.

Your Responsibilities as an Esperanza Patient:

1. Arrive on time for appointments, and call in advance to cancel if you cannot come.
2. Provide all information about your past care, illnesses and medications to your health care provider when he/she is trying to find out the best possible treatment for you.
3. Inform your provider of anticipated problems in following any prescribed treatment plan.
4. Request additional information or clarification about your health or treatment when you do not fully understand the information or instructions.
5. Provide accurate health insurance information at the time of each visit, and pay at the time services are received.
6. Provide supporting financial documentation if you have no insurance; notify us when your financial situation changes; and pay at the time services are received.
7. Receive an explanation of your bill, and to meet with billing staff to discuss payments.
8. Supervise your children in the center.
9. Request referrals at least 2 full business days prior to the time it is needed.
10. Not bring drugs, alcohol or weapons of any kind to Esperanza Health Center.
11. Be respectful and honest in dealing with staff; be considerate of other patients.

Privacy Practices in English

Privacy Practices in Spanish