MAP Behavioral Health Center (MAP-BHC) is committed to providing high quality, respectful, and compassionate care for those working to overcome difficulties with mental health and psychological issues. 


Clients (and their legal guardian, if applicable) will be informed to their rights and responsibilities as a client of MAP-BHC and will be ensured appropriate venues for addressing any concern regarding their rights and responsibilities. 


  • Explanation of Rights – Each resident and their legal guardian, if applicable, will be given a written statement of rights and responsibilities as a client of MAP-BHC.
  • Written Statement of Resident Rights and Responsibilities – A written copy of MAP-BHC and Responsibilities shall be posted in the common reception area.
  • Client Rights are as follows:
    • Be treated with curtesy, dignity, and respect for your individuality by those providing services and to receive courteous, considerate care and professional services;
    • Be free from discrimination or exploitation due to age, race, color, creed, religion, national origin, sex, marital status, disability, sexual orientation and public assistance status while seeking services;
    • Be free from maltreatment or abuse as defined by the Vulnerable Adults Protection Act or Maltreatment of Minors (Minnesota Statutes section 626.5572, subdivision 15 or section 626.556);
    • Personal privacy, individually and cultural identity; privacy will be respected by all staff;
    • Confidentiality of records and other protected health information, consistent with the requirements of state and federal law, and as defined in MAP-BHC’s “Notice of Privacy Policy & Practices”;
    • Be informed that some information from clinical files (with your name removed) may be used for purposes of research, program evaluation, or training; 
    • Receive accurate information about MAP-BHC, its practitioners, services, clinical guidelines, and client rights and responsibilities; 
    • Expect that all practitioners meet training and experience qualifications required by state law, and continually work toward maintaining expertise in providing clinical services to individuals seeking mental health and psychological services;
    • Be informed of the cost of professional services before receiving the services;
    • Receive information about your diagnosis and summary information of completed questionnaires, and to participate in an informed way in the decision-making process regarding your treatment;
    • Receive individualized treatment, including initial assessment; a collaboratively developed treatment plan; periodic treatment plan reviews; and a treatment plan supervised and carried out by competent, qualified and experienced professional staff;
    • Have family members or significant others participate in the planning of your treatment; 
    • Refuse treatment or care recommended by a practitioner;
    • Provide recommendations or suggestions about MAP-BHC to the agency director;
    • Voice concerns, grievances or appeals about MAP-BHC or a staff member to the Director of Operations, or the Executive Director as outlined in MAP-BHC’s Grievance Policy and Procedures (posted in the lobby and available upon request);
    • Contact Minnesota licensing boards for public data on licensed therapists, or to report practitioner specific complaints:
      • MN Board of Psychology, 2829 University Ave SE, #320, Minneapolis, MN 55414-3237. Phone (612) 617-2230
      • MN Board of Social Work, 2829 University Ave SE, #340, Minneapolis, MN 55414-3239. Phone (612) 617-2100
      • MN Board of Marriage & Family Therapy, 2829 University Ave SE, #330, Minneapolis, MN 55414-3239. Phone (612) 617-2220
      • MN Board of Behavioral Health and Therapy, 2829 University Ave SE, #210, Minneapolis, MN 55414-3250. Phone (612) 617-2178
      • MN Board of Medical Practice, 2829 University Ave SE, #500, Minneapolis, MN 55414-2130. Phone (612) 617-2130
      • MN Board of Nursing, 2829 University Ave SE, #200, Minneapolis, MN 55414-3250. Phone (612) 617-2270

Client Responsibilities

As a client of MAP-BHC, you have the responsibility to:

  • Openly share the concerns that brought you to seek therapy and/or psychological services, and to provide, to the extent possible, information that MAP-BHC staff needs in order to provide optional care for you;
  • Treat other clients and client information with respect and confidentiality; client treatment information learned in various treatment settings must be kept private and confidential; 
  • Participate, to the degree possible, in understanding your behavioral health problems, developing mutually agreed upon treatment goals, and engaging in treatment;
  • Actively work toward your treatment goals and participate in your healing processes and psychological objectives;
  • Keep scheduled appointments and give at least 24 business hours prior cancellation notice when unable to keep your appointment. A pattern of failed appointments may result in discontinuation of services; 
  • Be aware that not following treatment recommendations may compromise your health and safety, including leading to very serious medical and psychological consequences;
  • Notify your therapist or psychologist if your condition worsens or if you are having difficulty keeping yourself safe. In a crisis, if you are unable to reach your therapist during regular working hours or if the center is closed, assistance is available by calling:
    • Miller-Dwan Medical Center
      24 hours a day, 7 days a week
      (218) 723-0099
    • Text LIFE to 61222
      24 hours a day, 7 days a week, 365 days a year
    • Birch Tree Center
      (218) 623-1800
    • Bethany Youth Crisis Shelter
      24 hours a day, 7 days a week
      (218) 626-2726
    • Lutheran Social Service Crisis Nursery
      (218) 302-6879
    • PAVSA
      24 hours a day
    • 911 or going to the nearest emergency department
Name *
I am 18 years of age or older. *
Date Of Birth *
Date Of Birth
If Under 18: Parent / Guardian Name
If Under 18: Parent / Guardian Name
Date Today *
Date Today
Signature *