Important Notices - AFC LaPorte

Proficiency of Language Assistance Services

1. ATTENTION(English): If you do not speak English, we are able to provide you language assistance services, free of charge, please contact Ed Humphreys at 205.380.5530 or complianceofficer@americanfamilycare.com
2. ATENCIÓN (Spanish): Si usted no habla Inglés, somos capaces de proporcionarle a usted servicios de asistencia lingüística, de forma gratuita, por favor, póngase en contacto con Ed Humphreys al 205.380.5530 or complianceofficer@americanfamilycare.com
3. 注意 (Chinese)：如果您不会说英语，我们可以免费为您提供语言协助服务，请联系Ed Humphreys：205.380.5530或,complianceofficer@americanfamilycare.com
4. 주의(Korean): 당신이 영어를하지 않을 경우, 우리는 무료로, 205.380.5530 또는380.5530, complianceofficer@americanfamilycare.com에서 조쉬Ed Humphreys 에 문의하시기 바랍니다, 당신 언어 지원 서비스를 제공 할 수 있습니다
5. Chú ý (Vietnamese): Nếu bạn không nói được tiếng Anh, chúng tôi có thể cung cấp cho bạn các dịch vụ hỗ trợ ngôn ngữ, miễn phí, xin vui lòng liên hệ với Ed Humphreys tại 205.380.5530 hoặc 205.380.5530, complianceofficer@americanfamilycare.com
6. تنبيه (Arabic): إذا كنت لا يتكلمون الإنجليزية، ونحن قادرون على توفير لكم خدمات المساعدة اللغوية، مجانا، يرجى الاتصال جوش بوريل في380.5530 أو 205.380.5530، complianceofficer@americanfamilycare.com
7. ACHTUNG (German): Wenn Sie kein Englisch sprechen, können wir Ihnen kostenlos Sprachunterstützung anbieten, wenden Sie sich bitte an Ed Humphreys unter 205.380.5530 oder complianceofficer@americanfamilycare.com
8. ATTENTION (French): Si vous ne parlez pas anglais, nous sommes en mesure de vous fournir des services d’assistance linguistique, sans frais, s’il vous plaît contacter Ed Humphreys au 205.380.5530 ou complianceofficer@americanfamilycare.com
9. ધ્યાન(Gujarati): તમે ઇંગલિશ વાત ન હોય તો, અમે તમને ભાષા સહાય સેવાઓ પૂરી પાડવા માટે વિના મૂલ્યે, 205.380.5530 અથવા380.5530, complianceofficer@americanfamilycare.com પર જોશ બુરીલ સંપર્ક કરો સક્ષમ છે
10. ધ્યાન (Tagalog): તમે ઇંગલિશ વાત ન હોય તો, અમે તમને ભાષા સહાય સેવાઓ પૂરી પાડવા માટે વિના મૂલ્યે, 205.380.5530 અથવા complianceofficer@americanfamilycare.comપર જોશ બુરીલ સંપર્ક કરો સક્ષમ છે
11. ध्यान दें(Hindi): आप अंग्रेजी नहीं बोलता, तो हम, आप भाषा सहायता सेवाएं प्रदान करने के लिए नि: शुल्क, या380.5530, complianceofficer@americanfamilycare.com में जोश Humphreys संपर्क कृपया सक्षम होते हैं
12. ຄວນລະວັງ (Lao): ຖ້າຫາກວ່າທ່ານບໍ່ສາມາດເວົ້າພາສາອັງກິດ, ພວກເຮົາມີຄວາມສາມາດສະຫນອງບໍລິການທີ່ຊ່ວຍເຫຼືອພາສາ, ການຟຣີ, ກະລຸນາຕິດຕໍ່ Ed Humphreys ທີ່380.5530 ຫຼື complianceofficer@americanfamilycare.com
13. ВНИМАНИЕ (Russian): Если вы не говорите по-английски, мы можем предоставить Вам услуги языковой помощи, бесплатно, пожалуйста, свяжитесь с Джошем Баррилл на 205.380.5530 или complianceofficer@americanfamilycare.com
14. ATENÇÃO (Portuguese): Se você não fala Inglês, somos capazes de lhe fornecer serviços de assistência linguagem, de forma gratuita, entre em contato com Ed Humphreys em 205.380.5530 ou complianceofficer@americanfamilycare.com
15. DİKKAT (Turkish): Eğer İngilizce bilmiyorsanız, biz 205.380.5530 veya complianceofficer@americanfamilycare.com Ed Humphreys, size dil yardımı hizmetleri sağlamak ücretsiz, lütfen edebiliyoruz
16. 注意 (Japanese)：あなたが英語を話せない場合、私たちは380.5530またはcomplianceofficer@americanfamilycare.comでジョシュHumphreysを、あなたの言語支援サービスを提供し、無料で、連絡してくださいすることができます

American Family Care

Notice and Non-Discrimination Statement

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

• 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
• Provides free language services to people whose primary language is not English, such as:
  • Qualified interpreter services
  • Information written in other languages

If you need these services, please notify clinic staff.

If you believe that American Family Care 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:

Zikar Maredia, Clinic Owner

8850 Spencer Highway
Suite 100
LaPorte, TX 77571
Phone: 281-946-9980
zmaredia@afcurgentcare.com

You can file a grievance in person, by mail, or email.

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.