Notice of Nondiscrimination

This provider complies with applicable Federal civil rights laws and does not discriminate on the basis of age, race, color, national origin, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, or gender identity or expression. This provider does not exclude people or treat them differently because of age, race, color, national origin, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, or gender identity or expression. This provider:

• 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 the Risk Officer/ADA Coordinator at Middlebrook Surgery Center.

If you believe that this provider has failed to provide these services or discriminated in another way on the basis of age, race, color, national origin, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, or gender identity or expression, you can file a grievance with:

Risk Officer/ADA Coordinator
Middlebrook Surgery Center
1210 Tennova Medical Way
Knoxville, TN 37909
(865) 909-4949
TTY: (865) 909-4949
Fax: (865) 558-5356
regina.mayo@tennova.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Risk Officer/ADA Coordinator 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, DC 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 do not speak English, language assistance services, free of charge, are available to you.

ማስታወሻ:- የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡፡

লক্ষ্যকরুনঃযদিআপনিবাংলা কথাবলতেপারেন তাহলেনিঃখরচায়ভাষাসহায়তাপরিষেবাউপলব্ধআছে ।

Hagsesda: Iyuhno hyiwoniha Tsalagi gawonihisdi, Adasdalisgi gawonihisdi unadasdelvdi, asewui tla gohusdiyidagvwalida. Nihi etsadvnvisdanelvi.

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。

Hochefo;  Chahta anumpa ish anumpuli hokma, anumpa atoksvli vhleha yvt peh pilla chi apela hinla kvt maya.

XIYYEEFFANNAA: Afaan dubbattan Oroomiffatiin tajaajila gargaarsa afaanii, kanfaltii malee ni argattu.

LET OP: Als u Nederlands spreekt, kunt u gratis gebruikmaken van een tolkdienst.

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

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

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

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

ध्यान दें यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं।

LUS CEEB TOOM:  Yog tias koj hais lus Hmoob, kev pab cuamtxhais lus, yog  pab dawb xwb.

Nrụbama: Ọ b ụ ụ na ị na asụ Igbo, enyemaka as ụ ụ, bụ n’efu, dịịrị gị.

PAKDAAR: Nu saritaem ti Ilocano, ti serbisyo para ti baddang ti lengguahe nga awanan bayadna ket sidadaan para kenyam.

ATTENZIONE: se parla italiano, sono disponibili servizi di assistenza linguistica gratuiti.

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。

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

Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m̀ Ɓàsɔ́ɔ̀‑wùɖù‑po‑nyɔ̀ jǔ ní, nìí, à wuɖu kà kò ɖò po‑poɔ̀ ɓɛ́ìn m̀ gbo kpáa.

ເອົາໃຈໃສ່: ຖ້າທ່ານເວົ້າພາສາລາວ, ພວກເຮົາມີບໍລິການໃຫ້ຄວາມຊ່ວຍເຫຼືອດ້ານພາສາໂດຍບໍ່ເສຍຄ່າໃຊ້ຈ່າຍໄວ້ບໍລິການທ່ານ.

Kojela:  Elane kwoj aikuij kajin Majol, ijo ej lelok jiban ikijen kajin, ejelok onen, enaj iwoj nan kwe.

ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។

D77 baa ak0 n7n7zin: Diné Bizaad bee y1n7[ti’go , t’11 j77k’e saad bee 1k1 an1’1lwo’j7 ata hane’, bee n7k1 i’doolwo[.

ध्यान दिनुहोस् तपार्इंले नेपाली बोल्नुहुन्छ भने तपार्इंको निम्ति भाषा सहायता सेवाहरू निःशुल्क रूपमा उपलब्ध छ ।

Wann du Deitsch (Pennsylvania German / Dutch) schwetzscht, darrefscht du ebber griege, as aa Deitsch schwetzt un dich helfe kann mit die englisch Schprooch.

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

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

ਧਿਆਨ ਦਿਓ ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ ਤਾਂ ਭਾਸ਼ਾ ਵਿੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ।

ATENŢIE:  Dacă vorbiţi limba română, vă stau la dispoziţie servicii de asistenţă lingvistică, gratuit.

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

MO LOU SILAFIA:  Afai e te tautala i le Gagana Samoa, o loo iai auaunaga fesoasoani e fai fua, e leai se totogi mo oe

OBAVJEŠTENJE:  Ako govorite srpsko‑hrvatski, usluge jezičke pomoći dostupne su vam besplatno.

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

PAUNAWA:  Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo ng tulong sa wika.

เรียน ถ้าคุณพูดภาษาไทย คุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี

DİKKAT:  Eğer Türkçe konuşuyor iseniz, dil yardımı hizmetlerinden ücretsiz olarak yararlanabilirsiniz.

УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби підтримки.

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

ÀKÍYÈSÍ: Tí o ba ńsọ èdè Yorùbá ọ̀fẹ́ ni ìrànlọ́wọ́ lóri èdè wa fún yín o.