NON-DISCRIMINATION NOTICE

Discrimination is Against the Law

Premier Orthopaedics and Sports Medicine Associates, Ltd. (Premier) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. does not exclude people or treat them differently because of race, color, national origin, age,disability, or sex.

Premier :

• Will provide 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)
• Will provide 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 Jeanne Oliver, Chief Operating Officer.

If you believe that Premier 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:

Jeanne Oliver

Chief Operating Officer

3809 West Chester Pike, Suite 150,

Newtown Square, PA 19073

(P) 610-359-5660

(F) 610-853-3317

joliver@premierortho.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Theresa
Lobodzinski, Executive Assistant, 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

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1- 610-359-5660.
1-610-359-5660
CHÚ Ý: Nu bn nói Ting Vit, có các dch v h tr ngôn ng min phí dành cho bn. Gi s 1-610-359- 5660
1-610-359-5660.
Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 1-610-359-5660.
1-610-359-5660.
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-610-359-5660.)
5660-359-6101-1
ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-610-359-5660.
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-610-359-5660.

1-610-359-5660.

UWAGA: Jeeli mówisz po polsku, moesz skorzysta z bezpatnej pomocy jzykowej. Zadzwo pod numer 1-610-359-5660.

ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-610- 359-5660.

1-610-359-5660

ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-610-359- 5660.