Notice of Non-discrimination

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

Associates in Ophthalmology provides free aids and services to people with disabilities to communicate effectively with us, such as: qualified sign language interpreters and some written information in other formats upon request (large print, accessible electronic formats, other formats). We provide free language services to people whose primary language is not English, such as: qualified interpreters.

If you need these services, you may contact Michael Lutz, COO, Administrator. If you believe that Associates in Ophthalmology 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: Michael Lutz, COO, Administrator at 9970 Mountain View Drive, West Mifflin, PA 15122, or 412-650-3080 or mlutz@aiovision.com. You can file a grievance in person or by mail or phone. If you need help filing a grievance, Michael Lutz is available to assist 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, 1-800- 537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Statement of Nondiscrimination

Associates in Ophthalmology complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak a non-English language, assistance is available to you free of charge.

Centros de cirugía Associates, LLC cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.

SPANISH: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.

同夥外科中心有限責任公司遵守適用的聯邦民權法律規定不因種族、膚色、民族血統、年 齡、殘障或性別而歧視任何人。

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。

LANGUAGE ASSISTANCE SERVICES

ENGLISH: ATTENTION: If you speak English, language assistance services are available to you free of charge.

SPANISH: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.

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。

VIETNAMESE: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.

RUSSIAN: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.

PENNSYLVANIAN DUTCH*: Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch.
*detailed languages spoken at home and ability to speak English for the population 5 years and over: 2009-2013

KOREAN: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

ITALIAN: ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti.

ARABIC: ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم

FRENCH: ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement.

GERMAN: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.

GUJARATI: સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે.

POLISH: UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej.

FRENCH CREOLE: ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou.

MON-KHMER, CAMBODIAN: ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។ ចូរ ទូរស័ព្ទ

PORTUGUESE: ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis.