ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call [Number for Language Assistance Service] (TTY: [Number for TTY Service]).
Discrimination is Against the Law
Crater Community Hospice complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Crater Community Hospice does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Crater Community Hospice:
- 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 [Compliance Officer]
If you believe that Crater Community Hospice 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 Officer], 3916 South Crater Road, Petersburg, Virginia 23805, [Compliance Phone Number], TTY: [Number for TTY Service], [Compliance Fax Number], [Compliance Officer's Email]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, [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/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.