Patient Rights & Responsibilities

Effective Date: June 17, 2026

Elysian Medspa & Rejuvenation Center is committed to providing respectful, professional, safe, and individualized care.

A positive healthcare experience depends on communication, informed decision-making, mutual respect, and cooperation between patients, providers, and staff.

These rights and responsibilities apply to services provided by Elysian Medspa & Rejuvenation Center, including medical aesthetics, primary care, skincare, injectable treatments, laser services, dry eye treatment, weight management, IV hydration, telehealth, occupational health services, and DOT or CDL medical examinations.

Your Rights as a Patient

Respectful and Nondiscriminatory Care

You have the right to receive respectful, considerate, and professional care without unlawful discrimination.

You have the right to be treated with dignity and to have your personal values, beliefs, privacy, and preferences considered within the limits of safe and appropriate care.

Information About Your Care

You have the right to receive information about:

  • Your health condition or aesthetic concern
  • Recommended examinations or treatments
  • Reasonable alternatives
  • Expected benefits
  • Material risks and potential complications
  • Recovery and aftercare
  • Expected costs
  • The identity and professional role of individuals involved in your care

Information should be provided in a manner you can reasonably understand.

Participation in Decisions

You have the right to participate in decisions about your care.

You may ask questions, request additional explanation, discuss alternatives, and seek another professional opinion.

Informed Consent

You have the right to receive information reasonably necessary to make an informed decision before a procedure or treatment.

Certain services require separate written consent forms. Signing a consent form does not prevent you from asking questions or withdrawing consent before a procedure begins, subject to the circumstances and applicable law.

Refusal of Care

You may refuse a recommended examination, medication, procedure, or treatment.

We will explain reasonably foreseeable consequences of refusal when appropriate. We may ask you to document the refusal.

Refusing one service does not create a right to demand another service that a provider believes is unsafe, medically inappropriate, outside the provider’s scope, or contrary to applicable standards.

Privacy and Confidentiality

You have the right to privacy during consultations, examinations, and treatments, consistent with safe care and clinic operations.

You have the right to expect that health information will be handled according to applicable privacy laws and our HIPAA Notice of Privacy Practices.

Access to Medical Information

You may request access to your medical and billing records as permitted by law.

You may also request an amendment, confidential communications, restrictions, or an accounting of certain disclosures, as described in our HIPAA Notice of Privacy Practices.

Communication Assistance and Accommodations

You may request reasonable accommodations, communication assistance, auxiliary aids, accessible materials, or language assistance.

Requests will be evaluated according to your needs, the nature of the service, patient safety, available resources, and applicable law.

Support Persons and Chaperones

You may ask whether a support person or chaperone may be present during a visit or procedure.

The clinic may limit the presence of another person when necessary to protect privacy, safety, sterile technique, space, staff operations, or the rights of another patient.

A parent, guardian, healthcare representative, or other legally authorized person may participate when permitted by law.

Information About Charges

You have the right to ask about expected charges, insurance billing, payment options, and financial policies.

Insurance participation or benefit verification does not guarantee coverage or payment by your health plan.

Uninsured or self-pay patients may have a right to receive a Good Faith Estimate under federal law.

Continuity and Coordination

You have the right to receive reasonable information regarding follow-up care, referrals, prescriptions, test results, and other steps that are part of your treatment plan.

You are responsible for informing us when you need clarification or have not received an expected communication.

Complaints and Concerns

You have the right to express concerns or make a complaint without retaliation or an unreasonable effect on your care.

We encourage you to contact clinic administration so we can understand and address the concern.

For privacy complaints, contact our Privacy Officer or the Office for Civil Rights of the U.S. Department of Health and Human Services.

Emergency Care

Elysian Medspa & Rejuvenation Center is not an emergency department and is not designed to provide emergency medical services.

For a medical emergency, call 911 or go to the nearest emergency department.

Your Responsibilities as a Patient

Provide Accurate Information

You are responsible for providing complete and accurate information about:

  • Symptoms and concerns
  • Medical and surgical history
  • Medications and supplements
  • Allergies
  • Pregnancy or breastfeeding status
  • Prior treatments
  • Recent procedures
  • Adverse reactions
  • Substance use when clinically relevant
  • Insurance coverage
  • Changes in your health

Incomplete or inaccurate information may affect treatment safety, eligibility, results, insurance processing, or certification decisions.

Ask Questions

You are responsible for asking questions when you do not understand:

  • A diagnosis
  • A recommendation
  • A medication
  • A treatment plan
  • Risks
  • Costs
  • Preparation instructions
  • Aftercare instructions
  • Follow-up requirements

Tell us when you need information explained differently.

Follow the Agreed Plan

You are responsible for following preparation, medication, safety, aftercare, and follow-up instructions.

Tell your provider if you cannot or do not intend to follow a recommendation so that alternatives and risks can be discussed.

Report Problems Promptly

Contact us promptly about unexpected symptoms, complications, medication reactions, significant changes, or concerns following treatment.

Do not rely on social media or a general website form for urgent medical communication.

For an emergency, call 911 or go to the nearest emergency department.

Keep Appointments

You are responsible for arriving on time and providing reasonable notice when you must cancel or reschedule.

Late arrivals, missed appointments, and cancellations may be subject to clinic policies or fees disclosed during scheduling.

Meet Financial Obligations

You are responsible for:

  • Providing current insurance information
  • Understanding your health plan
  • Paying deductibles, copayments, coinsurance, non-covered services, and other patient balances
  • Obtaining required referrals or authorizations when assigned to the patient
  • Reviewing financial, membership, package, and cancellation terms before agreeing to them

Insurance billing does not guarantee that an insurer will pay.

Treat Others Respectfully

You are responsible for treating providers, staff, other patients, visitors, and clinic property respectfully.

Threats, harassment, discrimination, intimidation, violence, sexual misconduct, abusive behavior, property damage, or disruptive conduct may result in removal from the premises, termination of non-emergency services, or contact with law enforcement.

Protect Privacy

You may not photograph, record, livestream, or publish audio, video, images, or confidential information involving staff, providers, patients, or visitors without appropriate permission.

Recording may be limited to protect privacy, safety, and clinic operations.

Follow Safety and Facility Rules

You are responsible for following reasonable clinic rules concerning:

  • Infection control
  • Service animals
  • Children and guests
  • Medical equipment
  • Restricted areas
  • Smoking or vaping
  • Alcohol or impairing substances
  • Weapons
  • Photography and recording
  • Staff instructions

Weapons or conduct that creates a safety concern may be prohibited to the extent permitted by law.

Understand That Results Vary

You are responsible for understanding that medical, aesthetic, wellness, and weight-management outcomes vary.

No provider can guarantee a specific result, duration, response, weight change, cosmetic outcome, or absence of complications.

DOT and CDL Examination Responsibilities

Patients seeking a DOT physical or CDL medical examination are responsible for:

  • Providing complete and accurate medical information
  • Bringing required identification, medications, eyewear, hearing devices, records, and forms
  • Disclosing conditions and treatments relevant to federal qualification standards
  • Providing requested specialist records or testing
  • Understanding that certification is determined under applicable standards

Scheduling or paying for an examination does not guarantee certification, a particular certification period, or approval by an employer, licensing authority, or government agency.

Clinic Rights and Responsibilities

Elysian Medspa & Rejuvenation Center will seek to:

  • Provide care within applicable professional and legal standards
  • Maintain appropriate privacy and security safeguards
  • Explain recommended care
  • Obtain required consent
  • Respond to reasonable questions
  • Provide reasonable accommodation and communication assistance where required
  • Maintain a safe environment
  • Address concerns fairly

The clinic may decline, postpone, modify, or discontinue non-emergency services when:

  • A service is not medically appropriate
  • Required information is unavailable
  • A patient does not meet eligibility criteria
  • Safety instructions are not followed
  • Necessary consent cannot be obtained
  • The requested service is outside the provider’s scope
  • Payment or administrative requirements are not satisfied
  • Conduct threatens safety or substantially disrupts operations
  • Continuing the relationship would violate law or professional obligations

When legally or clinically required, we will provide appropriate notice, emergency instructions, or information regarding continuity of care.

Questions or Concerns

Contact:

Elysian Medspa & Rejuvenation Center
6280 Shadeland Ave., Suite A
Indianapolis, IN 46220
Phone: (317) 526-5090
Email: info@elysianmedirejuv.com