NOTICE OF NONDISCRIMINATION of
Terk Oncology Center
for Prostate Care & Breast Conservation
Terk Oncology Center for Prostate
Care & Breast Conservation complies with applicable Federal civil rights laws and does not discriminate on the basis of
race, color, national origin, age, disability, or sex. Terk Oncology Center for Prostate Care & Breast Conservation
does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Terk Oncology Center for Prostate Care & Breast Conservation:
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 Terk Oncology Center for
Prostate Care & Breast Conservation
If you believe that Terk Oncology Center
for Prostate Care & Breast Conservation 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: Mitchell Terk, MD, 7017 AC
Skinner Parkway Jacksonville, FL 32256 , Telephone Number: 1-904-520-6800, Fax Number: 1-904-520-6801,
Email: mterk@floridaprostate.com,. You can file a grievance in person or by mail, fax, or
email. If you need help filing a grievance, Mitchell Terk, MD 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, D.C.
20201 1-800-368-1019, 800-537-7697 (TDD)
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 1-904-520-6800 (TTY:
Dial 711 ).
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd
pou lang ki disponib gratis pou ou. Rele 1-904-520-6800 (TTY: Dial 711 )
CHÚ
Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ
ngôn ngữ miễn phí dành cho bạn. Gọi số 1-904-520-6800 (TTY: Dial 711
).
ATENÇÃO: Se fala português, encontram-se disponíveis
serviços linguísticos, grátis. Ligue para 1-904-520-6800 (TTY: Dial 711 ).
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 1-904-520-6800 （TTY：1-904-520-6800 ）。
ATTENTION : Si
vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-904-520-6800
(ATS : 1-904-520-6800 ).
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang
gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-904-520-6800 (TTY: Dial 711 ).
ВНИМАНИЕ: Если вы
говорите на русском
языке, то вам доступны
бесплатные услуги перевода.
Звоните 1-904-520-6800 (телетайп:
1-904-520-6800 ).
ملحوظة: إذا
كنت تتحدث اذكر اللغة،
فإن خدمات المساعدة اللغویة
تتوافر لك بالمجان. اتصل
برقم 1-904-520-6800 ) رقم .(904-494-8051-1 :والبكم
الصم ھ
ATTENZIONE: In caso la lingua parlata sia l'italiano,
sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-904-520-6800 (TTY: Dial 711 ).
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen
zur Verfügung. Rufnummer: 1-904-520-6800 (TTY: Dial 711 ).
주의: 한국어를 사용하시는
경우, 언어 지원
서비스를 무료로 이용하실
수 있습니다. 1-904-520-6800
(TTY: Dial 711 )번으로 전화해
주십시오
UWAGA: Jeżeli mówisz
po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-904-520-6800 (TTY:
Dial 711 ).
સુચના: જો તમે ગુજરાતી
બોલતા હો, તો નિ:શુલ્ક
ભાષા સહાય સેવાઓ
તમારા માટે ઉપલબ્ધ
છે. ફોન કરો 1-904-520-6800 (TTY: Dial 711 ).
เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี
โทร 1-904-520-6800 (TTY: Dial 711 ).
NOTICE OF NONDISCRIMINATION
