Notice Informing Individuals About Nondiscrimination and
Accessibility Requirements

Discrimination is Against the Law. Tampa Outpatient Surgical Facility complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Tampa Outpatient Surgical Facility does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Tampa Outpatient Surgical Facility provides free aids and services to people with disabilities to communicate effectively with us, such as: qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). We also provide free language services to people whose primary language is not English, such as: qualified interpreters and information written in other languages.

If you need these services, please contact the facility at (813) 875-0562. If you believe that Tampa Outpatient Surgical Facility 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 Compliance or Civil Rights Coordinator at 5013 N Armenia Ave, Tampa, FL 33603 or 813-875-0562 (phone) or (813)871-5236 (fax). You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Compliance or Civil Rights 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/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 or 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

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Español (Spanish):
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 813-875-0562.

Kreyòl Ayisyen (French Creole):
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 813-875-0562.

Português (Portuguese):
ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 813-875-0562.

Français (French):
Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 813-875-0562.

Русский (Russian):
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 813-875-0562.

Italiano (Italian):
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 813-875-0562.

한국어 (Korean):
주의: 한국어를 사용하시는 경우, 언어 지원
서비스를 무료로 이용하실 수 있습니다. 813-875-0562. 번으로 전화해 주십시오.

ગજુ રાતી (Gujarati):
ચનુ ા: જો તમે જરાતી બોલતા હો, તો િ ન: કુ ભાષા
સહાય સેવાઓ તમારા માટ ઉપલ ધ છ. ફોન કરો 813-875-0562.

Tiếng Việt (Vietnamese):
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số. 813-875-0562.

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813-875-0562.

Tagalog (Tagalog – Filipino):
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 813-875-0562.

رقم(Arabic):
تتحدث كنت إذا :ملحوظة
اتصل .بالمجان لك تتوافر اللغویة المساعدة خدمات فإن ،اللغة اذكر
.برقم
813-875-0562

Deutsch (German):
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 813-875-0562.

Polski (Polish):
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 813-875-0562.

ภาษาไทย (Thai):
เรยีน:ถา้คณุพดูภาษาไทยคณุสามารถใชบ้รกิารชว่ยเหลอืทางภาษาไดฟ้รีโทร
. 813-875-0562.

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