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Disruptive Patient Behavior Contract Template

Disruptive Patient Behavior Contract Template 2026

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The Disruptive Patient Behavior Contract establishes a framework for maintaining respectful and collaborative relationships between healthcare providers and patients. It defines disruptive behavior, outlines expectations for patient conduct, and specifies consequences for violations. The contract emphasizes mutual respect, details prohibited actions, and provides procedures for reporting disruptive incidents. It also includes a process for appealing actions taken against patients due to disruptive behavior while ensuring access to urgent medical care.

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What are unacceptable patient behaviors?

Disrespectful, derogatory or prejudiced language or conduct, or prejudiced requests for accommodation of personal preferences on the part of either patients or physicians can undermine trust and compromise the integrity of the patient-physician relationship, the Code of Medical Ethics says.

How to write a behaviour contract?

1) I will not verbally abuse any person or persons within the vicinity of (insert address). 2) I will not damage any property that belongs to XXXX. 3) I will not shout or be abusive to other residents in the vicinity of the property.

What is an example of a behaviour contract?

They consist of several essential elements that contribute to their effectiveness. In this section, we will explore three key components of a behavior contract: clear and specific goals, measurable and observable behavior, and reinforcement and consequences.

How to document patient upset?

In the patients medical record, document exactly what you saw and heard. Start with the date and time the incident occurred, the location, and who was present. Describe the patients violent behavior and record exactly what you and the patient said in quotes.

How to document patient refusal?

As with the informed consent process, informed refusal should be documented in the medical record and include the following: describe the intervention offered; identify the reasons the intervention was offered; identify the potential benefits and risks of the intervention;