NONDISCRIMINATORY POLICY

Ensures education of and public awareness of Civil Right

It is the policy of Tomoka Surgery Center not to discriminate on the basis of race, color, national origin,

sex, age or disability.

CIVIL RIGHTS COMPLIANCE

Tomoka Surgery Center complies with applicable Federal civil rights laws and does not discriminate on

the basis of race, color, national origin, age, disability, or sex. Tomoka Surgery Center does not exclude

people or treat them differently because of race, color, national origin, age, disability, or sex.

LANGUAGE ASSISTANCE

Tomoka Surgery Center provides services to people with disabilities to communicate effectively with us,

such as:

  • Qualified sign language interpreters
  • Written information if other formats can be requested and made readily available, other formats may include (large print, audio, accessible electronic formats, other formats)
  • Provides 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 Business Office Manager.

If you believe that that we have 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:

Julie Herring, Business Office Manager

Tomoka Surgery Center

345 Clyde Morris Blvd, Ste 300

Ormond Beach, FL 32174

Phone: 386-672- 7575

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our

Business Office Manager 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, DC 20201

1-800- 868-1019, 800-537- 7697 (TDD).

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

Language Services Assistance Available

ATTENTION: If you speak a foreign language assistance services, free of charge, are available to you.

Call 386-672- 7575.

Specific translations for Notice of Nondiscrimination, Nondiscrimination and Taglines are available at:

http://www.hhs.gov/civil-rights/for- individuals/section-1557/translated- resources/

رقم (Arabic) ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم.

繁體中文 (Chinese)

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電

Kreyòl Ayisyen (French Creole)

ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou.

Français (French)

ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement.

Deutsch (German)

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur

Verfügung.

Italiano (Italian)

ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica

gratuiti.

한국어 (Korean)

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

Polski (Polish)

UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej.

Português (Portuguese)

ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis.

Русский (Russian)

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.

Español (Spanish)

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.

Tagalog (Tagalog – Filipino)

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika

nang walang bayad.

ภาษาไทย (Thai)

เรียน: ถา้ คุณพูดภาษาไทยคุณสามารถใชบ้ ริการช่วยเหลือทางภาษาไดฟ้ ร

Tiếng Việt (Vietnamese)

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.