Patient Rights & Responsibilities

Pavilion Surgery Center observes and respects a patient’s rights and responsibilities without regard to age, race, color, sex, national origin, religion, culture, physical or mental disability, personal values or belief systems.


  • Considerate, respectful and dignified care, and respect for personal values, beliefs and preferences.
  • Have a family member (or other representative of his/ her choosing) and his/her own physician notified promptly of his/her admission to the facility.
  • Know the name of the physician who has primary responsibility for coordinating his/her care and the names and professional relationships of other physicians and non-physicians who will see him/her.
  • Know if your physician fails to have, or has malpractice insurance that is either expired and/or lapsed.
  • Expect the center to disclose, when applicable, physician financial interests or ownership in the center.
  • Receive information about health status, diagnosis, prognosis, course of treatment, prospects for recovery and outcomes of care (including unanticipated outcomes) in terms that can be understood.
  • Make decisions regarding medical care, and receive as much information about any proposed treatment or procedure in order to give informed consent or refuse a course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved, alternate courses of treatment or non-treatment and the risks involved in each, and the name of the person who will carry out the procedure or treatment.
  • To be advised if the facility/personal physician proposes to engage in or perform human experimentation affecting your care or treatment. The patient has the right to refuse to participate in such research projects.
  • Appropriate assessment and management of your pain, information about pain, pain relief measures and to participate in pain management decisions.
  • Formulate advance directives regarding his/her healthcare, and to have facility staff and practitioners who provides care in the facility comply with these directives (to the extent provided by state laws and regulations).
  • Know this center’s policy regarding advance directives and how to obtain more information from the State of California regarding advance directives and how to obtain further information.
  • Have personal privacy respected. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly.
  • Confidential treatment of all communications and records pertaining to the care and visit. The patient will receive a separate “Notice of Privacy Practices” that explains his/her rights in detail and how we may use and disclosure of protected health information.
  • Access information contained in your records within a reasonable time frame, except in certain circumstances specified by law.
  • Receive care in a safe setting, free from mental, physical, sexual or verbal abuse and neglect, exploitation or retaliation by staff. The patient has the right to access protective services and advocacy services including notifying government agencies of neglect or abuse.
  • Be free from restraints and seclusion of any form used as a means of coercion, discipline, convenience or retaliation by staff.
  • Reasonable continuity of care and to know in advance the time and location of appointments as well as the identity of the persons providing the care.
  • Be informed by the physician, or a delegate of the physician, of continuing healthcare requirements and options following discharge from the facility.
  • Examine and receive an explanation of the facility’s bill regardless of the source of payment.
  • Exercise these rights without regard to sex, race, color, religion, ancestry, national origin, age, disability, medical condition, marital status, sexual orientation, gender identity, gender expression, educational background, economic status, or the source of payment for care. Irvine Surgical Partners, LLC does not exclude, deny benefits to, or otherwise discriminate against any person on these bases in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by Irvine Surgical Partners, LLC, directly or through a contractor or any other entity with which Irvine Surgical Partners, LLC, arranges to carry out its programs and activities.


The care a patient receives depends partially on the patient himself. Therefore,
in addition to these rights, a patient has certain responsibilities as
well. These responsibilities should be presented to the patient in the
spirit of mutual trust and respect:

  • To provide complete and accurate information to the best of your ability regarding your health, any medications, including over the counter products and dietary supplements, and any allergies or sensitivities.
  • To provide complete information concerning your present complaints, past medical history, and other matters relating to your health.
  • To inform us if you do not clearly comprehend the course of your medical treatment and what is expected of you.
  • To follow the treatment plan established by your physician, including instructions of nurses and other health professionals as they carry out your physicians’ orders.
  • For your actions, should you refuse treatment or not follow your physician’s orders.
  • To accept personal financial responsibility for any charges not covered by your insurance and to assure the financial obligations of your care are fulfilled as promptly as possible.
  • To be considerate of the rights of other patients and to be respectful of all healthcare professionals and staff.
  • For your valuables and personal property, and for respecting the property of others.
  • To provide a copy of your Advance Directive upon arrival.
  • Provide a responsible adult to transport you to home from the facility and remain with you for 24 hours if required by your provider.
  • If you do not understand these rights and responsibilities, or if you have additional questions, please ask to speak with the Administrator for further explanation.

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Inquiries, grievances, or complaints related to this non-discrimination policy may be directed to:


Pavilion Surgery Center
1140 W. La Veta Ave., Ste. 300
Orange, CA 92868


Voice or file a grievance regarding treatment or care that is, or fails to be, furnished without fear of reprisal. If you want to file a grievance you may do so by writing or calling:


Pavilion Surgery Center
1140 W. La Veta Ave., Ste. 300
Orange, CA 92868


File complaint with the state Department of Public Health Service by writing
or calling:

Department of Public Health
681 South Parker Street, Suite 200
Orange, CA 92868

714-567-2906 or 800-236-9747

File a complaint with AAAHC:

5250 Old Orchard Road, Suite 200
Skokie, Illinois 60077


File a complaint through the Medicare Beneficiary Ombudsman via their website or by calling:


Get In Touch With Us

If you would like to receive more information or to provide us with feedback on those areas where we have done well, and those where we may need to improve, please fill out the form below and a representative will get back to you shortly. If this is a medical emergency, call 911 immediately. For your security, please do not use email to share personal information, health information, social security numbers or credit card numbers. Instead, we recommend contacting your clinic and/or doctor directly.