[[Hospital Name]] Nondiscrimination Notice

[[Hospital Name]] complies with applicable Federal civil rights laws and does not discriminate on the basis of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation and gender identity or expression. [[Hospital Name]] does not exclude people or treat them differently because of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation and gender identity or expression.

[[Hospital Name]]:

  • Provides free auxiliary aids and services to people with disabilities to communicate effectively with us, such as:
    • qualified sign language interpreters, video remote interpreting or other aids for hearing impaired individuals
    • written information in multiple formats including large print, audio, accessible electronic formats, or other formats for visually impaired individuals
  • Provides free language services to people whose primary language is not English, such as:
    • qualified interpreters or a language line
    • information written in other languages

If you need these services, contact [[Hospital Name]]’s ADA Coordinator at [[Hospital Phone Number]].

If you believe that [[Hospital Name]] 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:

ADA Coordinator

3501 E. Speedway Blvd. Suite 300
Tucson, AZ 85716
Fax: 520-318-7156
feedback@carondelet.org

You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, [[Hospital Name]]’s ADA Coordinator 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/smartscreen/main.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
1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf

Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 512-754-7700.

Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 512-754-7700.

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 512-754-7700.

Korean: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 512-754-7700. 번으로 전화해 주십시오.

Arabic: ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 512-754-7700.

Urdu:لاک ۔ ںیہ بایتسد ںیم تفم تامدخ یک ددم یک نابز وک پآ وت ،ںیہ ےتلوب ودرا پآ رگا :رادربخ ںیرک 512-754-7700.

Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 512-754-7700.

French: ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 512-754-7700.

Hindi: ध्यान द: यद आप हदी बोलते ह तो आपके िलए मुफ्त म भाषा सहायता सेवाएं उपलब्ध ह। 512-754-7700

Farsi: توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 512-754-7700 تماس بگیرید.

German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 512-754-7700.

Gujarati: સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 512-754-7700.

Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 512-754-7700.

Japanese: 注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。512-754-7700. まで、お電話にてご連絡ください。

Lao: ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 512-754-7700.