PrevHealth Folsom PC
800 W MacDade Blvd, Suite A, Folsom, PA 19033
267-814-2533 · prevhealth.us/folsom
800 W MacDade Blvd, Suite A, Folsom, PA 19033
267-814-2533 · prevhealth.us/folsom
Notice of Nondiscrimination
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Page 1
PREVHEALTH FOLSOM PC PAGE 1 OF 2
Notice of Nondiscrimination
PrevHealth Folsom PC complies with applicable federal civil
rights laws and does not discriminate on the basis of race,
color, national origin (including limited English proficiency
and primary language), age, disability, or sex.
We provide, free of charge:
For people with disabilities: reasonable modifications and
appropriate auxiliary aids and services, such as qualified sign
language interpreters and written information in other
formats (large print, audio, accessible electronic formats).
For people whose primary language is not English:
language assistance services, such as qualified interpreters
and information written in other languages.
To request these services, contact Ruby Parvaiz,
Director of Administration and Human Resources, at
1-888-773-8456.
Page 1 of 2 · Continued on next page
Page 2
NOTICE OF NONDISCRIMINATION (CONTINUED) PAGE 2 OF 2 If you believe PrevHealth Folsom PC 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: Ruby Parvaiz Director of Administration and Human Resources 800 W MacDade Blvd, Suite A, Folsom, PA 19033 Phone: 1-888-773-8456 · Email: ruby@prevhealth.us You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, online at ocrportal.hhs.gov, 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 1-800-368-1019, 800-537-7697 (TDD) Complaint forms are available at hhs.gov/ocr/office/file/index.html. This notice is available on our website: www.prevhealth.us
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PREVHEALTH FOLSOM PC Free Language Assistance and Accessibility Services ATTENTION: If you speak a language other than English, free language assistance services are available to you. Appropriate auxiliary aids and services to provide information in accessible formats are also available free of charge. Call 1-888-773-8456 (TTY: 711) or speak to your provider. This notice is posted with translations in the languages most commonly spoken in Pennsylvania.
Page 4
PREVHEALTH FOLSOM PC
Notice of Availability of Language Assistance Services and Auxiliary Aids and Services
ATTENTION: If you speak a language other than English, free language assistance services are available to you. Appropriate auxiliary
aids and services to provide information in accessible formats are also available free of charge. Call 1-888-773-8456 (TTY: 711) or
speak to your provider.
SPANISH · ESPAÑOL FRENCH · FRANÇAIS
ATENCIÓN: Si habla español, tiene a su disposición servicios ATTENTION : Si vous parlez français, des services d’assistance
gratuitos de asistencia lingüística. También están disponibles linguistique gratuits sont à votre disposition. Des aides et
de forma gratuita ayuda y servicios auxiliares apropiados para services auxiliaires appropriés pour fournir des informations
proporcionar información en formatos accesibles. Llame al 1- dans des formats accessibles sont également disponibles
888-773-8456 (TTY: 711) o hable con su proveedor. gratuitement. Appelez le 1-888-773-8456 (TTY: 711) ou parlez à
votre fournisseur.
CHINESE · 中文
注意：如果您说中文，我们将免费为您提供语言协助服务。我们还免 GERMAN · DEUTSCH
费提供适当的辅助工具和服务，以无障碍格式提供信息。致电 1- ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen
888-773-8456（文本电话：711）或咨询您的服务提供商。 kostenlose Sprachassistenzdienste zur Verfügung.
Entsprechende Hilfsmittel und Dienste zur Bereitstellung von
VIETNAMESE · TIẾNG VIỆT Informationen in barrierefreien Formaten stehen ebenfalls
LƯU Ý: Nếu bạn nói tiếng Việt, chúng tôi cung cấp miễn phí các kostenlos zur Verfügung. Rufen Sie 1-888-773-8456 (TTY: 711)
dịch vụ hỗ trợ ngôn ngữ. Các hỗ trợ dịch vụ phù hợp để cung an oder sprechen Sie mit Ihrem Provider.
cấp thông tin theo các định dạng dễ tiếp cận cũng được cung
cấp miễn phí. Vui lòng gọi theo số 1-888-773-8456 (Người GUJARATI · ગુજરાતી
khuyết tật: 711) hoặc trao đổi với người cung cấp dịch vụ của ધ્યાન આપો: જો તમે ગુજરાતી બોલતા હો તો મફત ભાષાકીય સહાયતા સેવાઓ તમારા
bạn. માટે ઉપલબ્ધ છે. યોગ્ય ઑક્ઝિલરી સહાય અને ઍક્સેસિબલ ફૉર્મેટમાં માહિતી પૂરી
પાડવા માટેની સેવાઓ પણ વિના મૂલ્યે ઉપલબ્ધ છે. 1-888-773-8456 (TTY: 711)
RUSSIAN · РУССКИЙ પર કૉલ કરો અથવા તમારા પ્રદાતા સાથે વાત કરો.
ВНИМАНИЕ: Если вы говорите на русском, вам доступны
бесплатные услуги языковой поддержки. Соответствующие POLISH · POLSKI
вспомогательные средства и услуги по предоставлению UWAGA: Osoby mówiące po polsku mogą skorzystać z
информации в доступных форматах также предоставляются bezpłatnej pomocy językowej. Dodatkowe pomoce i usługi
бесплатно. Позвоните по телефону 1-888-773-8456 (TTY: 711) zapewniające informacje w dostępnych formatach są również
или обратитесь к своему поставщику услуг. dostępne bezpłatnie. Zadzwoń pod numer 1-888-773-8456 (TTY:
711) lub porozmawiaj ze swoim dostawcą.
PENNSYLVANIA DUTCH · PENNSYLVANISCH DEITSCH
ACHTUNG: Wann du Pennsylvanisch Deitsch schwetzscht, sin HAITIAN CREOLE · KREYÒL AYISYEN
Hilfsdienst fer die Sprooch fer dich gratis verfügbar. Passende ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd
Hilfsmittel un Dienscht, fer Informatione in zugängliche aladispozisyon w gratis pou lang ou pale a. Èd ak sèvis
Formate ze gebbe, sin aa gratis verfügbar. Ruf 1-888-773-8456 siplemantè apwopriye pou bay enfòmasyon nan fòma aksesib
(TTY: 711) oder schwetz mit dein Anbieter. yo disponib gratis tou. Rele nan 1-888-773-8456 (TTY: 711) oswa
pale avèk founisè w la.
KOREAN · 한국어
주의: 한국어를 사용하시는 경우 무료 언어 지원 서비스를 이용하실 수 있 KHMER (CAMBODIAN) · ភាសាខ្មែរ
습니다. 이용 가능한 형식으로 정보를 제공하는 적절한 보조 기구 및 서비 សូមយកចិត្តទុកដាក់៖ ប្រសិនបើអ្នកនិយាយ ភាសាខ្មែរ សេវាកម្មជំនួយភាសាឥតគិត
스도 무료로 제공됩니다. 1-888-773-8456 (TTY: 711) 번으로 전화하거 ថ្លៃគឺមានសម្រាប់អ្នក។ ជំនួយ និងសេវាកម្មដែលជាការជួយដ៏សមរម្យ ក្នុងការផ្តល់
나 서비스 제공업체에 문의하십시오. ព័ត៌មានតាមទម្រង់ដែលអាចចូលប្រើប្រាស់បាន ក៏អាចរកបានដោយឥតគិតថ្លៃ
ផងដែរ។ ហៅទូរសព្ទទៅ 1-888-773-8456 (TTY: 711) ឬនិយាយទៅកាន់អ្នក
ITALIAN · ITALIANO ផ្តល់សេវារបស់អ្នក។
ATTENZIONE: se parli italiano, sono disponibili servizi di
assistenza linguistica gratuiti. Sono inoltre disponibili PORTUGUESE · PORTUGUÊS
gratuitamente ausili e servizi ausiliari adeguati per fornire ATENÇÃO: Se você fala Português do Brasil, serviços gratuitos
informazioni in formati accessibili. Chiama il 1-888-773-8456 de assistência linguística estão disponíveis para você. Auxílios e
(TTY: 711) o parla con il tuo fornitore. serviços auxiliares apropriados para fornecer informações em
formatos acessíveis também estão disponíveis gratuitamente.
ARABIC · العربية Ligue para 1-888-773-8456 (TTY: 711) ou fale com seu provedor.
فستتوفر لك خدمات المساعدة اللغوية، إذا كنت تتحدث اللغة العربية:تنبيه
كما تتوفر وسائل مساعدة وخدمات مناسبة لتوفير المعلومات.المجانية
1-888-773-8456 اتصل على الرقم.بتنسيقات يمكن الوصول إليها مجانًا
.( أو تحدث إلى مقدم الخدمةTTY: 711)
For free language assistance or accessibility services,
call 1-888-773-8456 (TTY: 711).