You possess the same civil, human, and legal rights as all other citizens. You have the right to be treated with courtesy, respect, and full recognition of your individuality and dignity. All consumers of services are guaranteed freedom from abuse, neglect, exploitation, humiliation, and retaliation.

You have the right to have your records kept confidential and only released with your fully informed, signed consent. You have the right to review your record at any reasonable time and add written comments to clarify information you believe is inaccurate or incomplete. No one else can access your records unless you specifically authorize it, except in cases outlined in the complete Rights booklet. Kennebec Counseling adheres to applicable state and federal policies regarding confidentiality and the protection of health information.

You have the right to an Individualized Plan developed in collaboration with your provider, tailored to your needs and goals. The Plan must be in writing, and you are entitled to a copy. The Plan will clearly outline the responsibilities of all parties, the timelines for achieving tasks and goals, and the criteria for measuring success. The Plan will be based on your actual needs, and if a necessary service is unavailable, it will detail how your need will be met.

No services or treatments can be administered against your will. If you have a legal guardian, they are authorized to make decisions on your behalf. You have the right to be informed of the potential risks and anticipated benefits of all services and treatments, including medications, in a manner you understand. You are encouraged to ask questions to your provider or anyone else you trust before making any decisions about your treatment or services. If a guardian has been appointed to make decisions for you, they must be fully informed of all risks and benefits of the proposed treatments or services.

You have the right to appoint a representative of your choice to assist you in understanding your rights, protecting your rights, or working on your treatment or service plan. If you wish to appoint a representative, you must do so in writing. You can access your representative at any time and may change or cancel the designation at your discretion.

You cannot be secluded or restrained in an outpatient setting under any circumstances.

If you believe any of your rights have been violated at Kennebec Counseling, you (or a personal representative) have the right to file a grievance as follows:

1. Discuss your concern with your primary clinician, who will make every effort to resolve the issue informally.

2. If informal resolution is not successful, your primary clinician will provide information on how to pursue a formal grievance. You will also be informed of how to contact the Kennebec Counseling Complaint Officer, who can assist you in navigating the grievance process.

You have the right to receive a written response to your grievance, including the reasons for the decision. You may appeal any decision to the Department of Health and Human Services. You will not face any form of punishment for filing a grievance.

For assistance with filing a grievance, you may contact:

• Grievance Coordinator, DHHS, Substance Abuse and Mental Health Services: 11 State House Station - 41 Anthony Avenue, Augusta, ME 04333 | Phone: (207) 287-2595 | TTY Users: Dial 711 (Maine Relay)

• Disability Rights Maine: 160 Capitol Street, Suite 4, Augusta, Maine 04330 | Phone: 1-800-452-1948

• National Alliance on Mental Illness (NAMI): 52 Water Street, Hallowell, Maine 04347 | Phone: (207) 622-5767 or 1-800-464-5767

• Maine Equal Justice Partners: 126 Sewall Street, Augusta, Maine 04330 | Phone: (207) 626-7058 or 1- 866- 626-7059

Your rights to due process are further specified in the full document entitled "Rights of Recipients of Mental Health Services," a copy of which is available upon request.