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Complaint forms are available at:
https://www.hhs.gov/civil-rights/filing-a-complaint

Non-Discrimination

Pacific Anesthesia, P.C. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Pacific Anesthesia, P.C. does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

The facilities that Pacific Anesthesia, P.C. serves.

Provide free aids and services to people with disabilities to communicate effectively with us, such as:

  • Qualified sign language interpreters
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)

Provide free language services to people whose primary language is not English, such as:

  • Qualified interpreters
  • Information written in other languages

If you need these services, contact the facility where you will be having your procedure. If you believe that Pacific Anesthesia or the facility at which you had surgery has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with the facility or with:

  • Pacific Anesthesia Compliance Chair
  • 11808 Northup Way, W-105
  • Bellevue, WA 98005
  • Telephone: 425-284-1545
  • Fax: 425-284-1546

​You can file a grievance in person or by mail, fax, or email using the “Contact Us” option on this site. If you need help filing a grievance, the surgical facility or Pacific Anesthesia is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

  • U.S. Department of Health and Human Services
  • 200 Independence Avenue
  • SW Room 509F, HHH Building
  • Washington, D.C. 20201
  • Telephone: 1-800-368-1019
  • TDD: 800-537-7697