Annual Respect/Conduct Consent Logo
  • Annual Respect and Conduct Consent

  • At Bridge Family Practice, we are committed to creating a safe, respectful, and professional environment for all patients, staff, and providers. To uphold this standard, we ask that all individuals adhere to the following expectations:

    Mutual Respect Commitment

    • I agree to treat all providers, staff, and fellow patients with courtesy, dignity, and professionalism.
    • I understand that disrespectful, aggressive, threatening, or inappropriate behavior will not be tolerated and may result in dismissal from the practice.
    • I acknowledge that Bridge Family Practice staff is held to the same standards, and I have the right to expect respectful, compassionate, and professional care at all times.

    Communication & Conduct

    • I will communicate honestly and respectfully, whether in person, by phone, or electronically. That verbal abuse, harassment, or discriminatory language is grounds for immediate termination of services.
    • I agree to follow clinic policies and procedures designed to protect the safety and well-being of all individuals.

    Consent & Acknowledgment

    By signing below, I confirm that:

    • I have read and understood the expectations outlined in this form, and have had the opportunity to ask questions and receive clarification.
    • I consent to comply with the respectful conduct standards set forth by Bridge Family Practice.
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