Notice Informing Individuals About Nondiscrimination and Accessibility Requirements

Discrimination is Against the Law

Southern Jersey Family Medical Centers complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, and gender identity). Southern Jersey Family Medical Centers does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, and gender identity)

Southern Jersey Family Medical Centers:

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 our Compliance Officer.

If you believe that Southern Jersey Family Medical Centers has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, and gender identity), you can file a grievance with:

Compliance Officer,
1 Executive Drive, Suite 400, Marlton, NJ 08053
609-567-0434,
Fax: 609-704-5511,
Email: sjfmc@sjfmc.org

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our compliance officer 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://www.hhs.gov/ocr/complaints/index.html.

English

Sample Notice of Availability of Language Assistance Services and Auxiliary Aids and Services (§ 92.11)

ATTENTION: If you speak 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 1-800-486-0131 or speak to your provider.

Español

Español ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. También están disponibles de forma gratuita ayuda y servicios auxiliares apropiados para proporcionar información en formatos accesibles. Llame al 1-800-483-0131 o hable con su proveedor.

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 1-800-486-0131 或咨询您的服务提供商。

한국어

주의: [한국어]를 사용하시는 경우 무료 언어 지원 서비스를 이용하실 수 있습니다. 이용 가능한 형식으로 정보를 제공하는 적절한 보조 기구 및 서비스도 무료로 제공됩니다. 1-800-486-0131 번으로 전화하거나 서비스 제공업체에 문의하십시오.

Português do Brasil

Modelo de aviso de disponibilidade de serviços de assistência linguística e auxílios e serviços auxiliares (§ 92.11)

ATENÇÃO: Se você fala português, serviços gratuitos de assistência linguística estão disponíveis para você. Estão também disponíveis gratuitamente ajudas e serviços auxiliares adequados para fornecer informações em formatos acessíveis. Ligue para 1-800-486-0131 ou fale com seu provedor.

ગુજરાતી

ધ્યાન આપો: જો તમેગુજરાતી બોલતા હો તો મફત ભાષાકીય સહાયતા સેવાઓ તમારા માટ ઉપલબ્ધ છે. યોગ્ય ઑક્ઝિલરી સહાય અનેઍઝસેક્સબલ ફૉમેટમાાંમાક્હતી પૂરી પાડવા માટની સેવાઓ પણ ક્વના મૂલ્યેઉપલબ્ધ છે. 1-800-486-0131 પર કૉલ કરો અથવા તમારા પ્રદાતા સાથેવાત કરો.

POLSKI

UWAGA: Osoby mówiące po polsku mogą skorzystać z bezpłatnej pomocy językowej. Dodatkowe pomoce i usługi zapewniające informacje w dostępnych formatach są również dostępne bezpłatnie. Zadzwoń pod numer 1-800-486-0131 lub porozmawiaj ze swoim dostawcą

Italiano

Esempio di avviso di disponibilità di servizi di assistenza linguistica e di ausili e servizi ausiliari (§ 92.11)

ATTENZIONE: se parli Italiano, sono disponibili servizi di assistenza linguistica gratuiti. Sono inoltre disponibili gratuitamente ausili e servizi ausiliari adeguati per fornire informazioni in formati accessibili. Chiama l’1-800-486-0131 o parla con il tuo fornitore.

العربية

تنبيه: إذا كنت تتحدث [أدخل اللغة] ، فإن خدمات المساعدة اللغوية المجانية متاحة لك. كما تتوفر مجانا مساعدات وخدمات مساعدة مناسبة لتوفير المعلومات بأشكال يسهل الوصول إليها. اتصل بالرقم 1-800-486-0131 أو تحدث إلى مزودك.

Tagalog

PAALALA: Kung nagsasalita ka ng Tagalog, magagamit mo ang mga libreng serbisyong tulong sa wika. Magagamit din nang libre ang mga naaangkop na auxiliary na tulong at serbisyo upang magbigay ng impormasyon sa mga naa-access na format. Tumawag sa 1-800-486-0131 o makipag-usap sa iyong provider.”

РУССКИЙ

ВНИМАНИЕ: Если вы говорите на русский, вам доступны бесплатные услуги языковой поддержки. Соответствующие вспомогательные средства и услуги по предоставлению информации в доступных форматах также предоставляются бесплатно. Позвоните по телефону 1-800-486-0131 или обратитесь к своему поставщику услу.

Kreyòl Ayisyen

ATANSYON: Si w pale kreyòl, sèvis asistans pou lang gratis disponib pou ou. Èd oksilyè ki apwopriye ak sèvis pou bay enfòmasyon ki nan fòma aksesib yo disponib tou gratis. Rele 1-800-486-0131 oswa pale ak founisè w la.

हिंदी

ध्यान दें: यदि आप हिंदी बोलते हैं, तो आपके लिए निःशुल्क भाषा सहायता सेवाएं उपलब्ध होती हैं। सुलभ प्रारूपों में जानकारी प्रदान करने के लिए उपयुक्त सहायक साधन और सेवाएँ भी निःशुल्क उपलब्ध हैं। 1-800-486-0131 पर कॉल करें या अपने प्रदाता से बात करें।”

Việt

LƯU Ý: Nếu bạn nói tiếng Việt, chúng tôi cung cấp miễn phí các dịch vụ hỗ trợ ngôn ngữ. Các hỗ trợ dịch vụ phù hợp để cung cấp thông tin theo các định dạng dễ tiếp cận cũng được cung cấp miễn phí. Vui lòng gọi theo số 1-800-486-0131 hoặc trao đổi với người cung cấp dịch vụ của bạn.

Français

Modèle d’avis de disponibilité des services d’assistance linguistique et des aides et services auxiliaires (§ 92.11) ATTENTION : Si vous parlez Français, des services d’assistance linguistique gratuits sont à votre disposition. Des aides et services auxiliaires appropriés pour fournir des informations dans des formats accessibles sont également disponibles gratuitement. Appelez le 1-800-486-0131 ou parlez à votre fournisseur. »

اردو

توجہ: اگر آپ اردو بولتے ہیں، تو آپ کے لیے مفت زبان کی مدد کی خدمات دستیاب ہیں۔ قابل رسائی فارمیٹس میں معلومات فراہم کرنے کے لیے مناسب معاون امداد اور خدمات بھی مفت دستیاب ہیں۔ 1-800-486-0131 پر کال کریں یا اپنے فراہم کنندہ سے بات کریں۔