Treatment Consent | Metropolitan Pediatrics
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Treatment Consent

Welcome to Metropolitan Pediatrics! We’re happy to be your family’s medical home and help you reach your health goals. Here’s some important information about our clinic before we begin.

How We Care for You

As your medical home, we’re here to give your child and family proactive, personalized care. Your child will have a care team that includes a medical provider and a medical assistant. Sometimes, this team might also include a care manager, a behavioral health clinician, a lactation consultant, health care students, or other specialists, depending on your child’s needs.

We can help families with more than just medical issues. We also help with social, emotional, developmental, learning, and behavioral health concerns. Our main goal is to keep kids and teens healthy by making sure they get the best care.

When you sign our Treatment Consent form, you’re giving permission for Metropolitan Pediatrics staff and providers to:

  • Do physical exams and routine care
  • Order and perform tests
  • Give treatments that your provider prescribes

If treatment is needed, your provider will clearly explain the procedure, other choices you have, and any risks involved. You’ll have a chance to ask questions and get answers.

If special procedures are needed, your provider will talk with you about them, and you might need to sign more consent forms.

Behavioral Health Support

Our behavioral health team will work with you to meet your family’s specific needs. It’s a collaborative process, and we encourage you to ask questions or share any goals you have. You can ask for changes to your treatment or stop treatment at any time.

If your medical provider recommends medication for a behavioral health issue, they’ll discuss the risks, benefits, and other options with you. When you accept a prescription, you agree to follow the provider’s advice for all parts of the treatment.

Protecting Your Privacy

The privacy of your information is very important to us. Information shared between our providers is confidential.

  • In Oregon, people who are 14 or 15 years old can legally consent to medical and mental health treatment and to share information.
  • If parents are divorced, separated, or have other parenting agreements, both parents have equal access to their child’s chart information, unless a court order says otherwise.

Metropolitan Pediatrics keeps all your care records in one chart. We’ll keep your chart for 10 years from your last visit or until you turn 21, whichever is longer.

As your health care provider, we share information about your health with providers and clinics involved in your care without your written permission. We will, however, get your written permission to share records with individuals that are not involved directly in your care.

Exceptions to obtaining permission include:

  • If we suspect a child, elderly person, or disabled person is being abused.
  • If there’s a serious threat to the health or safety of yourself or others.
  • When important medical information is needed for emergency medical treatment.
  • When records are requested by a judge’s order, or if you waive your right to confidentiality.

Your insurance company will need information to process a claim. This usually includes your diagnosis, treatments, and the dates of your visits. Sometimes, they request more information. Your child’s file might be reviewed by Metropolitan Pediatrics or your insurance company to check for quality. We’ll keep your information private during this process.

Metropolitan Pediatrics respects the right of a child, parent, or adult to keep certain information private between themselves and their health care provider. If you have concerns about this, please tell your provider. Please let us know if you only want us to contact you in a specific way or at certain phone numbers.

Messaging Your Care Team

Using email and fax to communicate can have some privacy risks. The patient portal (MyHealth) is the safest way to send secure messages to your care team. Please know that emails or MyHealth messages are not a substitute for office visits and are not for immediate or urgent messages.

Your Health Insurance

Your provider has an agreement with your insurance company to offer services within certain limits. Here’s some information about different insurance plans:

  • Insurance Plans: Payments from your insurance plan depend on the benefits specific to your plan. Please check your policy and understand what your plan covers.
  • Managed Care Insurance: Your plan might only cover medical or behavioral health services that are “medically necessary.” It’s your responsibility to make sure any necessary pre-approvals are up to date. In addition, some insurance plans require you to select a Primary Care Provider (PCP), and may only cover services provided from that group. It is your responsibility to make sure your insurance company has the correct PCP.
  • Outside Services: Your insurance plan may cover labs, imaging, specialist visits, and/or services at other facilities at different levels depending on if they are “in-network” or “out-of-network.” It is your responsibility to check with your insurance company to confirm benefits and coverage.

Appointment Reminders

We will remind you about upcoming appointments based on your communication preferences. You may update these preferences at any time through the portal or by talking to one of our staff.

Reaching Your Provider

We answer phone calls between 7:30 AM and 5:30 PM, Monday through Friday (some clinics may have longer weekday or weekend hours). We will try to call you back within 24 hours. If you need to reach a provider after hours, you can call your clinic’s regular phone number to reach our answering service.

Sharing Your Concerns

If you have concerns about this treatment consent, or you’re unhappy with your care for any reason, please talk with your provider or our staff. If your concern is not resolved, you may ask to speak to a manager. We will respond within 2 business days.

Assistive Technology in Your Care

Some of our providers use AI tools to help turn an audio recording into a written note. This helps them document what happens during your visit. That way, they can spend more time focusing on your care instead of typing notes. One of these tools is DAX Copilot.

These tools follow strict rules to keep your personal health information safe and secure. Your provider will always review, correct, and approve all notes for accuracy.

Before recording you during any visit, your provider will ask your permission. You always have the right to say no or stop the recording at any time. If you have questions about these tools, or the notes they create, you can talk to your provider or contact the practice manager for more information.

Download a Copy

Patient Rights & Responsibilities

  • Billing and Financial Policies
  • Notice of Privacy Practices
  • Genetic Privacy Notice
  • Treatment Consent
  • Parental Separation or Divorce Policy
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