Non Discrimination – Section 1557

OCR NOTICE OF NONDISCRIMINATION
Source: HHS Office for Civil Rights

Stephen G.Nelson M.D., PA complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Stephen G.Nelson M.D., PA does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Stephen G.Nelson M.D., PA : • 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) • 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 Civil Rights Coordinator/Practice Manager.

If you believe that Stephen G.Nelson M.D., PA 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: Practice Manager/Civil Rights Coordinator 5601 Dr. MLK Jr. St. N St. Petersburg, FL 33704 727-525-2161 (Phone) 727-527-1968 (Fax).

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Practice Manager/Civil Rights 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 Toll Free: 1-800-868-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

SPANISH ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-727-525-2161

PORTUGUESE ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-727-525-2161

Tiếng Việt (Vietnamese): Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-727-525-2161

TAGALOG PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-727-525-2161

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。請致電1-727-525-2161

ITALIAN ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-727-525-2161

GUJURATI: સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-727-525-2161

POLISH UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-727-525-2161

RUSSIA ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-727-525-2161

FRENCH CREOLE ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-727-525-2161

FRENCH ATTENTION: Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-727-525-2161

GERMAN ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-727-525-2161

ARABIC: ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم
1-727-525-2161

KURDISH: ئاگاداری: ئھگھر بھ زمانی کوردی قھسھ دەکھیت، خزمھتگوزاریھکانی یارمھتی زمان، بھخۆڕایی، بۆ تۆ بھردەستھ.
1-727-525-2161

FARSI: توجھ: اگر بھ زبان فارسی گفتگو می کنید، تسھیلات زبانی بصورت رایگان برای شما .بگیرید تماس
1-727-525-2161