Notice of Nondiscrimination
Notice of Nondiscrimination
Yuill Black, M.D. and Michael R. Kletz, M.D., 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. Yuill Black, M.D.
and Michael R. Kletz, M.D., P.C. does not exclude people or treat them differently because of race, color,
national origin, age, disability, or sex.
Yuill Black, M.D. and Michael R. Kletz, M.D., P.C.:
- Provides 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)
- 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 Barbara Holland, a civil rights coordinator.
If you believe that Yuill Black, M.D. and Michael R. Kletz, M.D., P.C. 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: Barbara Holland, Regional Manager, Office for Civil Rights, U.S. Department of
Health and Human Services, 150 S. Independence Mall West, Suite 372, Public Ledger Building,
Philadelphia, PA 19106-9111, Phone: 800-368-1019, TDD: 800-537-7697, Fax: 202-619-3818,
E-mail: ocrmail@hhs.gov . You can file a grievance in person or by mail, fax, or E-mail. If you need help
filing a grievance, Barbara Holland, Regional 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, S.W. Room 509F, HHH Building Washington, D.C. 20201,
800-368-1019, TDD: 800-537-7697.
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html .
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-726-9891.
ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-800-726-9891.
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 1-800-726-9891.
ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-800-726-9891.
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag
sa 1-800-726-9891.
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-726-9891.
ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-800-726-9891.
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero –
1-800-726-9891.
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-726-9891.
Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m̀ [Ɓàsɔ́ɔ̀-wùɖù-po-nyɔ̀] jǔ ní, nìí, à wuɖu kà kò ɖò po-poɔ̀ ɓɛ́ìn m̀ gbo kpáa. Ɖá 1-800-726-9891.
Ntị: Ọ bụrụ na asụ Ibo, asụsụ aka ọasụ n’efu, defu, aka. Call 1-800-726-9891.
AKIYESI: Bi o ba nsọ èdè Yorùbú ọfé ni iranlọwọ lori èdè wa fun yin o. Ẹ pe ẹrọ-ibanisọrọ yi 1-800-726-9891.
ল য্করনঃ িযদ আিপন বাংলা, কথা বেলত েপারন, তােহল ি◌নঃখরচায় ভাষা সহায়তা িপেরষবা উপল েআছ। ে◌ফান করন ১-1-800-726-9891.
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。1-800-726-9891 まで、お電話にてご連絡くだ
さい。
늱넍: 뼑霢꽩ꌱ ꩡ끞뼍겑鱉 陲끥, 꽭꽩 덵낅 ꟹ걙ꌱ ꓩꊁꈑ 넩끞뼍겙 ꯍ 넽걪鱽鲙. 1-800-726-9891 냱ꈑ 놹쀉뼩 늱겢겑꿙.
เรียน: ถᕎาคุณพูดภาษาไทยคุณสามารถใชᕎบริการชᕍวยเหลือทางภาษาไดᕎฟรีโทร 1-800-726-9891.
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer:
1-800-726-9891.
ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-800-726-9891
توجھ: اگر بھ زبان فارسی گفتگو می کنید، تسھیلات زبانی بصورت رایگان برای شما فراھم می باشد.
با. 1-800-726-9891تماس بگیرید
خبردار: اگر آپ اردو بولتے ہیں، تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں ۔ کال
1-800-726-9891.کریں
यान द: यद आप हंद बोलते ह तो आपके िलए मुत म भाषा सहायता सेवाएं उपलध ह। 1-800-726-9891 पर कॉल कर।
