Patient Information

PATIENT RIGHTS

In New York State Healthcare consumers are guaranteed the right to:
  • Understand use of these rights, including interpretation, if necessary.
  • Privacy and Dignity.
  • Treatment regardless of race, creed, color religion, sex, national origin, disability, sexual orientation, age or source of payment.
  • Choice of health care provider and informed decision participation, in your treatment planning, decision and in plan formulation.
  • Have your treatment recorded and all information about you kept confidential.
  • Have access to your own medical record according to the Privacy Act of 1974.
  • Receive considerate and respectful care in a clean and safe environment.
  • To communicate freely with your provider, consumer service person, patient advocate, attorney and the courts.
  • Appropriate access to emergency services.
  • Procedures for resolving your complaints and grievances.
  • Enjoy all benefits and privileges guaranteed by law.
  • Be informed of the charges for services.
  • Refuse treatment and be told what effects this will have on your health.
If you are convinced that you have been denied any of your right, without good cause or without procedure, you may speak to a Director @ ext. 236, or call the NYS Department of Health (212) 268-6554

PATIENT REGISTRATION FORM

New Patient Registration Packet


If you have scheduled a first time appointment as a new patient, we kindly ask that you complete our New Patient Registration Packet to make sure that you understand your rights and responsibilities. It is very important that you read the forms and print them out prior to your visit. This will help to decrease your wait time and increase the time spent with your provider. 

 


Patient Forms For Your First Visit


 

 

 

We encourage you to review these forms as well



PATIENT REGISTRATION

New Patient Registration Packet


If you have scheduled a first time appointment as a new patient, we kindly ask that you complete our New Patient Registration Packet to make sure that you understand your rights and responsibilities. It is very important that you read the forms and print them out prior to your visit. This will help to decrease your wait time and increase the time spent with your provider. 

 


Patient Forms For Your First Visit


 

NOTICE OF PRIVACY ACKNOWLEDGEMENT / CONSENT FORM

BPMC DEMOGRAPHIC FORM

STATEMENT OF FINANCIAL RESPONSIBILITY

CONSENT FOR MEDICAL TREATMENT

PATIENTS' BILL OF RIGHTS

NOTICE OF PRIVACY PRACTICES

PATIENT PORTAL INFORMATION

Sign up for our Patient Portal Today! 

Get access to your medical records… 


Brooklyn Plaza Medical Center is very excited to help you access your medical records in a secure and convenient way. You will be able to manage and access your health information when and where you need it. 


With your personalized Patient Portal account, you can view your health information online anytime. It is accessible on the internet via your computer, or as an app for your smartphone. To sign up online after your first appointment, please stop by the front desk and speak to any of our staff. The staff will need your email address to web enable you in order to get the process started! 


The more you know about your healthcare, the greater our partnership can be. Using a secure password, you can log into the online Patient Portal 24 hours a day, 7 days a week to: 


  • Access and view test results 
  • View your healthcare summary, current health conditions and health history 
  • Securely communicate with our office online for non-urgent issues 
  • View current medications and request prescription renewals 
  • View current allergies, immunizations and preventive care screenings 
  • Request an appointment and view upcoming and past appointments 
  • Request and view referrals 
  • Contact our Office when you have a non-urgent question for your provider, you may send a secure message through the web portal. 


Questions about the patient portal

 

What is a Patient Portal?

The Patient Portal makes your health information more convenient to access.

 

The Patient Portal is a secure, confidential, and easy-to-use website that allows patients and their families 24-hour access to their medical records.

 

It uses the latest encryption technology to deliver secure communication between patients and providers.

 


Where can I gain secure access to my account? 

You can gain access to your patient portal account in 2 ways. 

If you need BPMC staff member to help you to complete the enrollment process, the front desk staff will assist you to set up your account by providing you with a username and temporary password. At BPMC, you can also visit our website, download the Healow app and the staff member will walk you through the entire enrollment process. 


If you decide to complete the enrollment process at home or on your smartphone, you will also need to go to BPMC website (www.brooklynplaza.org) and you can either enter the user name and temporary password you received from the front desk staff or you can create your own username and password. You will follow the system's instructions to open your private account. 




PATIENT PORTAL LOGIN