Hospice of Central Ohio complies with applicable Federal civil rights laws and does
not discriminate on the basis of race, color, national origin, age, disability, or sex.
Hospice of Central Ohio does not exclude people or treat them differently because
of race, color, national origin, age, disability, or sex.

Hospice of Central Ohio: 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 Privacy and Compliance Officer.
If you believe that Hospice of Central Ohio 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:

Privacy and Compliancy Officer
Hospice of Central Ohio
2269 Cherry Valley Rd.
Newark, OH, 43055
Telephone:(740)788-1400
Fax: (740)788-1401

You can file a grievance in person or by mail, fax, or email. If you need help filing a
grievance, our Privacy and 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.
ATTENTION: If you speak another language, language assistance services, free of
charge, are available to you. Call 1-740-788-1400.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia
lingüística. Llame al 1-740-788-1400.

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 1-740-788-1400
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche
Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-740-788-1400.

رقم( xxxxxxx-xxx-ملحوظة
:إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان .اتصل برقم 1
1400-788-740-1: والبكم الصم ھاتف.

Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus
Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff:
1-740-788-1400.

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные
услуги перевода. Звоните 1-740-788-1400.

ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont
proposés gratuitement. Appelez le 1-740-788-1400.

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.
Gọi số 1-740-788-1400.

XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan
ala, ni argama. Bilbilaa 1-740-788-1400.

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수
있습니다. 1-740-788-1400.

ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza
linguistica gratuiti. Chiamare il numero 1-740-788-1400.

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-
740-788-1400.

AANDACHT: Als u nederlands spreekt, kunt u gratis gebruikmaken van de taalkundige
diensten. Bel 1-740-788-1400.

УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до
безкоштовної служби мовної підтримки. Телефонуйте за номером 1-740-788-
1400.

ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență
lingvistică, gratuit. Sunați la 1-740-788-1400.