Hospital Patient Notices & Forms

As a patient at Hoag Orthopedic Institute hospital, you have certain rights and responsibilities that are inherent in your health care. To receive the best possible care, it is important that you play an active role in your medical treatment. It is the responsibility of your health care team at Hoag Orthopedic Institute to include you in that process.

Patient Rights & Responsibilities

Please select the English or Spanish translation of the Patient Rights & Responsibilities document below:

Patient Information Booklet

The following content is included in the Patient Information Booklet. In addition to the English Booklet, we also offer translated booklets linked below:

Pre-Admission Screening Form

Pre-Admission Screening (PAS) Form

Conditions of Admission Form

In order to care for our patient, all patients must sign Hoag Orthopedic Institutes Condition of Admission during the registration process. For your convenience, the Conditions of Admission is linked below for your review.

Advance Health Care Directive

Language Assistance Services

Notice to Consumers - Medical Board

Notice to Consumers - Physician Assistant Board

Notice to Consumers - Physical Therapy Board

Communication with Persons with Limited English Proficiency Policies

Please select the appropriate PDF below.

Auxiliary Aids and Services for Persons with Disabilities Policies

Please select the appropriate PDF below.

Patient Grievances

If you have questions or concerns about your care, a patient relations specialist is available to help you better understand the health care environment, resolve problems, provide information and address ethical concerns. You can contact Patient Relations at (949) 727-5151.

Contact DNV Healthcare

ATTN: Healthcare Complaints
DNV Healthcare USA Inc
1400 Ravello Dr
Katy, TX 77449
ONLINE COMPLAINT FORM: www.dnvhealthcare.com
(COMPLAINTS HYPERLINK): https://www.dnvhealthcareportal.com/patient-complaint-report)
COMPLAINTS E-MAIL: hospitalcomplaint@dnv.com
COMPLAINTS VOICEMAIL: 866-496-9647COMPLAINTS FAX: 281-870-4818

Contact the California Department of Public Health

You may file a complaint with the California Department of Public Health regardless of whether you use the hospital's grievance process.

By mail: California Department of Public Health
681 South Parker Street, Suite 200
Orange, CA 92868

By phone: (714) 567-2906
Toll Free: (800) 228-5234