Purpose of This Form
This form outlines the rights and obligations of clients receiving services from Therapist Cooperative Practice (TCP). We are committed to providing high-quality care while ensuring your rights are respected. Understanding your rights and responsibilities helps foster a collaborative and respectful care experience.
Your Rights as a Client
As a client of TCP, you have the right to:
1. Dignity and Respect
- Receive care that honors your personal dignity, beliefs, and preferences
- Be treated with kindness, respect, and courtesy by all staff
2. Privacy and Confidentiality
- Have your health information kept confidential and shared only as permitted by law
- Be informed of and consent to any information sharing, in compliance with HIPAA
3. Informed Consent
- Receive clear, understandable information about your care and services
- Participate actively in your care decisions and planning
4. Quality of Care
- Receive services from qualified professionals who provide safe, appropriate, and timely care
- Access care based on your individual needs, free of discrimination or bias
5. Participation and Involvement
- Be involved in developing and revising your care plan
- Invite family members or chosen representatives to participate in care decisions
6. Grievance and Complaint Process
- File complaints without fear of retaliation
- Receive timely responses and support in resolving issues
- Contact the appropriate board if needed:
- • Board of Behavioral Health (Suite 290)
- • Board of Social Work (Suite 245)
- • Board of Psychology (Suite 270)
- Address: 335 Randolph Ave, Saint Paul, MN 55102
7. Choice and Control
- Choose your care providers within agency capacity
- Request a change in caregivers when reasonably possible
8. Freedom from Abuse and Neglect
- Be protected from abuse, neglect, exploitation, or mistreatment
- Report concerns with the support of the agency
Your Responsibilities as a Client
As a client of TCP, you are responsible for:
1. Communication and Cooperation
- Provide accurate information about your health and any changes
- Collaborate with caregivers and follow agreed-upon care plans
2. Respect for Caregivers
- Treat staff with respect and courtesy
- Abide by our zero-tolerance policy for harassment or violence
3. Following the Care Plan
- Attend scheduled appointments and follow care instructions
- Notify the agency if you must miss an appointment
4. Financial Responsibility
- Follow the financial terms in your service agreement
- Communicate concerns about billing promptly
5. Safe Environment
- Ensure a safe and respectful environment for both yourself and caregivers
- Meet agency safety requirements in your home, if applicable
6. Reporting Changes
- Notify the agency of any changes in your health, contact details, or living arrangements
7. Use of Equipment
- Use any agency-provided equipment properly and according to instructions
- Report damage or issues promptly
Emergency Procedures
Crisis Situations
If you are experiencing a mental health emergency:
- Call 911 for immediate assistance
- Contact the National Suicide Prevention Lifeline: 988
- Go to your nearest emergency room
- Call our office for non-emergency urgent matters: (218) 302-4278
Contact Information
Office Address
1420 London Rd Suite 204
Duluth, MN 55805
Contact Details
Phone: (218) 302-4278
Fax: (218) 631-8101
Acknowledgment
By beginning therapy at Therapist Cooperative Practice, you acknowledge that you have read, understood, and agree to abide by these rights and responsibilities.
If you have any questions about this document, please discuss them with your therapist.