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Guaranteeing Your Rights

Advance Medical Directives are legal documents that allow you to give directions about your future medical care, in the event you become unable to communicate your wishes.

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Notice of Privacy Practices

This notice describes how your medical information may be used and disclosed, and how you can get access to this information. Please review it carefully.

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download Consent to Treat a Minor

Complete a Consent for Treatment of a Minor form to make sure a responsible adult has written permission to seek medical care for your child in your absence.

A male physician searches through paper patient records.

download Affidavit in Support of Medical Records Request (deceased patient)

If you'd like a copy of the medical records of a deceased patient, please complete a form and have it notarized.

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Release of Patient Information

The federal government established the HIPAA privacy rule in 2000, setting standards for the privacy of individually identified health information. Learn more, and how to access your medical records.

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Hearing Impairment & Language Assistance Information

If you're hearing impaired or need language assistance services, help is available free of charge.

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Patient Portal Forms

Authorization for CoxHealth Express
Activate your CoxHealth Express patient portal account when you can't be present at your provider's office, connect to your child's record, delegate a representative for your account or authorize another party to access your child's record through CoxHealth Express. 

CoxHealth Express Notice to Minor Patients to Restrict Access to Certain Medical Information
Minor patients ages 13 and older may restrict access to certain information in their medical record. 

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Non-Discrimination Information

Discrimination in provision of services is prohibited by law. Learn more.

What Every CoxHealth Patient Needs to Know

Patient and Client Bill of Rights

The goal of the Patient & Client Bill of Rights at CoxHealth is to inform patients and their family members of their rights and responsibilities. By recognizing and respecting the rights of each person and by conducting business in an ethical manner, we believe we can improve care, treatment, services, and outcomes. Care, treatment, and services are to be provided in a way that respects and fosters dignity, autonomy, positive self-regard, civil rights, and the involvement of patients and clients. The family is welcome to be involved in care, treatment, and service decisions with the recipient’s approval. People deserve care, treatment, and services that respect their cultural, psychosocial, and spiritual values.

The following serves as a basic overview regarding rights and responsibilities while a patient or client at CoxHealth. In addition to this basic overview several specialty care areas have rights statements which you may ask for such as obstetrics, pediatrics, psychiatrics, and geriatrics. When the words “patient” or “you/your” are used, they are also intended to designate clients and/or their legally authorized representative.

 Patients & Clients have the following rights to:

1. Receive treatment regardless of race, color, religion, veteran status, national origin (including ancestry, citizenship or any other subcategory of national origin recognized by applicable law), age, disability (physical, mental or other medical condition), sex (including marital status, family status, pregnancy, sexual orientation, gender identity, gender expression, or any other subcategory of sex recognized by applicable law) or any other basis prohibited by federal, state or local law in admission to, participation in, or receipt of services and benefits under any of its programs and activities including patient admissions, care (whether inpatient, outpatient or emergency in nature), room and floor assignments or patient services.

2. Be treated with respect and dignity. Patients will be cared for in an environment that preserves dignity and contributes to a positive self-image.

3. Choose who they want at their bedside when they are hospitalized, unless there is a clinical reason to restrict visitors.

4. Be involved in their care decisions. Patients have the right to their choice of health care providers. Patients have the right to fully participate in all decisions related to their health care and may include a designated family member or support person.

5. Participate in the development and implementation of their plan of care including but not limited to the following:

  • Make informed decisions regarding their care and give consent for that care. Consent should be given by the appropriate individual if the patient does not have the capacity to consent.
  • Be informed of their health status.
  • Be involved in care planning, treatment and discharge planning.
  • Request or refuse treatment being offered or suggested.
  • Formulate advance directives and have their wishes regarding end-of-life decisions honored when in the hospital setting. NOTE: Advance Directives are not honored within the outpatient/clinic setting providing episodic care (this includes primary and rural clinics).
  • Have practitioners and staff provide care that is consistent with patient directives.

6. Participate in research studies or clinical trials which have been approved for use at CoxHealth.

7. Expect an appropriate response to reports of pain and participate in the development and implementation of the pain management plan.

8. Privacy and confidentiality of their health information. For additional information, see the Notice of Privacy Practices.

9. Have the right to request their name not be included in the hospital patient listing (Facility Directory), which means the hospital staff will not acknowledge that they are a patient in the hospital. Patients also have the right to not provide their religious affiliation so that their name will not be provided to visiting community clergy or their designated staff. Unless we are told to restrict patient information, patients will be included in the patient listing and their name given to visiting community clergy.

10. Access the information contained in their medical records and request amendments when documentation is thought to be inaccurate or incomplete.

11. Effective communication that considers hearing, speech, and visual impairments as well as language barriers. CoxHealth provides free aids and services to people with disabilities to communicate effectively such as qualified sign language interpreters and written information in other formats (large print, audio, and other accessible electronic formats) as well as free language services to people whose primary language is not English, such as qualified interpreters and information in other languages. If you need these services, please contact the Nursing Administration Office, any CoxHealth employee or the Corporate Integrity Department.

If you are hearing impaired or are in need of language assistance services, such services are available to you free of charge. Call the operator at 417‑269‑6000 (1‑844‑563‑0782).

Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 417‑269‑6000 (1‑844‑563‑0782).

Chinese: 注意: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 1-417-269-6000 TTY:1-844‑563‑0782)

12. Physical access to the facility regardless of the patient’s physical impairment, if any.

13. Be protected against all forms of abuse, discrimination or harassment while a patient at CoxHealth.

14. Be free from seclusion and restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience, or retaliation by staff.

15. Request and receive an explanation of their bill for services.

16. Be adequately informed about the person(s) responsible for the delivery of their care, treatment and services and to have questions answered in regard to possible conflicts of interest the caregiver may have in that provision of care.

17. Be informed about the outcomes of the care provided, including unanticipated outcomes.

18. Have a concern or grievance addressed and resolved. See the Grievance Process.

19. Access protective or advocacy services and resources such as those offered by the State of Missouri. Contact information for some of these services is available upon request.

 Patient & Client Responsibilities and Commitment

 Patients & Clients have the responsibility to:

1. Communicate with caregivers their desires and to ask questions to ensure they understand the plan of care being considered.

2. Notify staff when they believe their rights have been violated. Patients may contact the Office of Patient Experience at 417‑269‑6101.

3. Provide adequate information to allow CoxHealth to bill any insurers, make arrangements for payment of services, or request financial assistance.

4. Not use recording devices such as cameras, video cameras, cell phones and similar devices in patient care areas. The use of recording devices is strictly prohibited without prior approval. Those who may intentionally or unintentionally capture electronic recordings without permission will be asked to delete such recordings from any devices used.

 Grievance Process

All staff should assist to resolve situations as soon as possible. Please allow management to hear and resolve any issue with your care experience. If a concern or grievance is not resolved at the point of services, patients should contact the most appropriate CoxHealth representative:

  • CoxHealth Office of Patient Experience: 417‑269‑6101
  • Ferrell-Duncan Clinic: 417‑875‑3334
  • CoxHealth Regional Services Clinics: 417‑269‑4343
  • Cox-Monett Hospital: 417‑354‑1417
  • Cox Medical Center Branson: 417‑348‑8580
  • Home Parenteral Services: 417‑887‑7525
  • Oxford Healthcare: 417‑883‑7500 or 1‑800‑637‑9201
  • If you believe CoxHealth has failed to provide services or discriminated in another way, you can file a grievance or receive help in filing a grievance by contacting the Corporate Integrity Department, 3801 South National Avenue, Springfield, MO 65807, Phone: 417‑269‑8806 or 1‑888‑340‑5297, Relay Missouri for hearing and speech impaired: 1‑800‑735‑2466 (voice) or 1‑800‑735‑2966 (text phone)

CoxHealth has a formal Grievance Process to find resolutions to concerns. This process is available to all patients, customers and families. We appreciate the opportunity to assist with any concerns about your care. As a patient, client, family member, community representative or employee of CoxHealth, you have the right to notify our accrediting agencies regarding any concern about the quality of care provided, safety of care provided, or safety of the environment in which care is provided. Anyone believing that he or she has pertinent and valid information about such matters that has not been addressed and/or resolved by the hospital or hospital’s management may notify:

  • Missouri Department of Health and Senior Services:
PO Box 570, Jefferson City, MO 658102,     1‑800‑392‑0210
  • United States Department of Health and Human Services:
 1‑800‑368‑1019 or 1‑800‑537‑7697 (TDD)
  • Missouri Department of Social Services:
 1‑800‑776‑8014 or 1‑800‑735‑2966 (TDD)
  • KEPRO Rock Run Center, Inc., 
5700 Lombardo Center Drive, Seven Hills, OH 44131 216‑447‑9604 or 1‑800‑589‑7337
  • For Hospital or Hospital Outpatient Services:
 DNV GL Healthcare, Inc., 1‑800‑496‑9647 fax:513‑947‑1250
400 Techne Center Drive, Suite 100, Milford, OH 45150
  • For Clinics or Regional Services: Accreditation Association of Ambulatory Health Care, Inc (AAAHC), 847‑853‑6060, fax: 847‑853‑9028
  • For Center for Prosthetics and Orthotics, CoxHealth Home Support, Home Parenteral Services, Oxford Healthcare Home Health/Hospice and Sleep Disorder Center:
 Accreditation Commission for Health Care (ACHC), 919‑785‑1214, fax: 919‑785‑3011

Patient admissions, room assignments and patient services are provided without regard to race, color, national origin, disability, age or sex.