Patient Rights & Responsibilities

1. Dignity and respect

You have the right to be treated with dignity, respect and courtesy, regardless of age, race, color, ethnicity, national origin, religion, sex, gender identity, sexual orientation, disability or ability to pay.

2. Clear information

You have the right to clear, complete and timely information about:

• The equipment or services recommended for you, and reasonable alternatives
• Expected benefits and known limitations of the equipment
• Delivery timelines, setup, training and follow-up
• Costs, what insurance is expected to cover, and your share, before services are provided
• Purchase or rental options, where your payer allows a choice
• Warranty coverage and how to get service or repairs
• How to reach our staff with questions or concerns

3. Medicare beneficiaries

If you have Medicare, you have the right to receive a copy of the Medicare DMEPOS Supplier Standards, and to be told in advance, usually with an Advance Beneficiary Notice (ABN), if we expect Medicare may not pay for an item, so you can decide whether to proceed.

4. Take part in decisions

You have the right to take part in decisions about your equipment, ask questions, express your preferences and have them considered during evaluation, selection and fitting.

5. Refuse equipment or services

You have the right to refuse recommended equipment or services. We’ll explain the possible consequences and note your decision in your record. Refusing won’t affect other services you’re entitled to.

6. Privacy and confidentiality

You have the right to have your personal and health information kept private and secure, as described in our Notice of Privacy Practices (HIPAA) and Privacy Policy, and as protected by federal and California law.

7. Access your records

You have the right to see and get copies of records we keep about you. Contact our Privacy Officer at info@bluebaymobility.com. We’ll respond within the time required by law, generally 30 days.

8. Safe, appropriate equipment

You have the right to equipment that is:

• Appropriate for your condition and functional needs
• Clean, sanitized and in safe working order
• Set up, fitted and adjusted by knowledgeable staff
• Delivered with clear instructions for safe use and care
• Covered by the applicable manufacturer warranty

9. Timely service and follow-up

You have the right to timely responses to questions, repair requests and follow-up needs, and to be told promptly if there’s a delay.

10. Voice concerns without retaliation

You have the right to raise concerns or complaints without fear of retaliation, and to have them addressed promptly and fairly under our Complaint and Grievance Procedure.

11. Non-discrimination

You have the right to services free from discrimination on the basis of race, color, national origin, age, disability, sex, religion, sexual orientation, gender identity or any other characteristic protected by federal or California law, including Section 504 of the Rehabilitation Act, Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act.

12. Language and communication help

If your main language isn’t English or you have a communication disability, you have the right to language assistance or communication support at no cost to you. Please let us know when you first contact us.

13. Know our accreditation status

You have the right to ask about our accreditation status and, if we are accredited, how to contact our accrediting organization with concerns.

1. Share accurate information

Give us accurate, complete information about your condition, functional needs, home environment, current and past equipment, and insurance.

2. Take part in evaluations and training

Take part in evaluations, fittings and training, and communicate openly with your therapist and our team.

3. Use equipment as directed

Use your equipment only as instructed and for its intended purpose. Please don’t modify custom equipment without talking to us first, because it may affect safety and void warranties.

4. Tell us about changes and problems

Let us know promptly if your condition, home or insurance changes in a way that affects your equipment, or if you have any problem or safety concern.

5. Keep appointments

Give us as much notice as possible if you need to reschedule an evaluation, fitting, delivery or service visit.

6. Meet financial responsibilities

Pay amounts you owe, such as co-pays, deductibles and costs not covered by insurance. If cost is a concern, talk to us before services are provided.

7. Treat staff with respect

Help keep every interaction respectful and safe. We hold ourselves to the same standard.

Questions or concerns

If you have questions about your rights or responsibilities, or want to talk to someone about a concern, please contact us. For formal complaints, see our Complaint and Grievance Procedure.

Effective date: October 15, 2026 (replaces the version effective May 10, 2026) · BlueBay Mobility Inc. · Tustin, CA 92780