Your Rights to File a Complaint or Grievance
Esta forma está disponible en Español
Our Commitment
Pacific Clinics believes that transformations in culture, practice and technology can provide the best experience to our clients. Working with clients, using strengths and needs to define and individualize service. We believe people should have the greatest possible access to services, as well as maximum voice and choice in planning, carrying out and evaluating those services.
Your Rights
You can file a complaint or grievance if you are not satisfied with the services you receive, feel that your Civil Rights have been violated, how you or your family were treated, feel you were discriminated or denied access to services which you were eligible to receive, or you have a complaint on how we used your Protected Health Information (PHI).
We encourage you to discuss your complaint(s) directly with the employee(s) of your program whenever possible, for possible resolution. Or if you prefer you can at any time, either verbally or in writing, file a complaint or grievance by completing a Client and Family Complaint Grievance Form available on www.PacificClinics.org, or in the lobby at all Agency locations, or send an email to ComplaintsAndGrievances@pacificclinics.org. Additionally you can mail your completed form to Compliance Officer, Pacific Clinics, 499 Loma Alta Ave. Los Gatos, CA 95030, or call the Compliance Hotline: 844-711-0266.
If you have concerns about how your personal information has been used you may also contact the Privacy Officer Phone: 408-364-4024 Email: privacyofficer@pacificclinics.org.
You will not be subject to discrimination, retaliation, or any other penalty for filing a complaint or grievance.
Confidentiality
We assure you that your complaint or grievance will be kept confidential, to the extent allowed by law, and will only be discussed with those people who are directly involved in the matter.
Who to Contact
If you have questions about your rights or how to file a complaint or grievance, ask your program representative or you may contact the Compliance Hotline: 844-711-0266.
Visit us on the web at www.PacificClinics.org
