Statement of Non-Discrimination

Discrimination is Against the Law

Keith Clinic Estramonte Chiropractic complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2)). Keith Clinic Estramonte Chiropractic does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.

Keith Clinic Estramonte Chiropractic provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as:

• Qualified sign language interpreters
• Written information in other formats (large print, audio, accessible electronic formats, other formats).

Keith Clinic Estramonte Chiropractic:

Provides free language assistance services to people whose primary language is not English, which may include:

• Qualified interpreters
• Information written in other  formats (large print, audio, accessible electronic formats, other formats).

If you need reasonable modifications, appropriate auxiliary aids and services, or language  assistance services, contact Miriam Aguilar.

If you believe that Keith Clinic Estramonte Chiropractic 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: 

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Miriam Aguilar, Compliance Officer, 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.

This notice is available at Keith Clinic Estramonte Chiropractic’s website: www.keithclinic.com 

If you do not speak English, language assistance services, free of charge, are available to you. Call 704-940-4000.

 

Spanish (Español)

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. También están disponibles de forma gratuita ayuda y servicios auxiliares apropiados para proporcionar información en formatos accesibles. Llame al 704-940-4000 o hable con su proveedor.

Chinese (中文)

注意：如果您說[中文]，我們可以為您提供免費語言協助服務。也可以免費 提供適當的輔助工具與服務，以無障礙格式提供資訊。請致電 704-940-4000 或與您的提供者討論。」

Vietnamese (Việt)

LƯU Ý: Nếu bạn nói tiếng Việt, chúng tôi cung cấp miễn phí các dịch vụ hỗ trợ ngôn ngữ. Các hỗ trợ dịch vụ phù hợp để cung cấp thông tin theo các định dạng dễ tiếp cận cũng được cung cấp miễn phí. Vui lòng gọi theo số 704-940-4000 hoặc trao đổi với người cung cấp dịch vụ của bạn.”

Korean (한국어)

주의: [한국어]를 사용하시는 경우 무료 언어 지원 서비스를 이용하실 수 있습니다. 이용 가능한 형식으로 정보를 제공하는 적절한 보조 기구 및 서비스도 무료로 제공됩니다. 704-940-4000 번으로 전화하거나 서비스 제공업체에 문의하십시오.”

French (Français)

ATTENTION : Si vous parlez Français, des services d’assistance linguistique gratuits sont à votre disposition. Des aides et services auxiliaires appropriés pour fournir des informations dans des formats accessibles sont également disponibles gratuitement. Appelez le 704-940-4000 ou parlez à votre fournisseur. »

Arabic (العربية)

تنبيه: إذا كنت تتحدث اللغة العربية، فستتوفر لك خدمات المساعدة اللغوية المجانية. كما تتوفر وسائل مساعدة وخدمات مناسبة لتوفير المعلومات بتنسيقات يمكن الوصول إليها مجانا. اتصل على الر 704-940-4000 أو تحدث إلى مقدم الخدمة” .

Hmong (Lus Hmoob)

LUS CEEV TSHWJ XEEB: Yog hais tias koj hais Lus Hmoob muaj cov kev pab cuam txhais lus pub dawb rau koj. Cov kev pab thiab cov kev pab cuam ntxiv uas tsim nyog txhawm rau muab lus qhia paub ua cov hom ntaub ntawv uas tuaj yeem nkag cuag tau rau los kuj yeej tseem muaj pab dawb tsis xam tus nqi dab tsi ib yam nkaus. Hu rau 704-940-4000 los sis sib tham nrog koj tus kws muab kev saib xyuas kho mob.”

Russian (РУССКИЙ)

ВНИМАНИЕ: Если вы говорите на русский, вам доступны бесплатные услуги языковой поддержки. Соответствующие вспомогательные средства и услуги по предоставлению информации в доступных форматах также предоставляются бесплатно. Позвоните по телефону 704-940-4000 или обратитесь к своему поставщику услуг.

Gujarati (ગુજરાતી)

ધ્યાન આપો: જો તમેગુજરાતી બોલતા હો તો મફત ભાષાકીય સહાયતા સેવાઓ તમારા માટ ઉપલબ્ધ છે. યોગ્ય ઑક્ઝિલરી સહાય અનેઍઝસેક્સબલ ફૉમેટમાાંમાક્હતી પૂરી પાડવા માટની સેવાઓ પણ ક્વના મૂલ્યેઉપલબ્ધ છે. 704-940-4000 પર કૉલ કરો અથવા તમારા પ્રદાતા સાથેવાત કરો.”

Khmer, Cambodian (ភាសាខ្មែរ)

សូ មយកចិត្តទុកដាក់៖ ប្រសិនបរើអ្នកនិយាយ ភាសាខ្មែរ បសវាកមែជំនួយភាសា ឥត្គិត្ថ្លៃគឺមានសប្មារ់អ្នក។ ជំនួយ និងបសវាកមែខ្ែលជាការជួយែ៏សមរមយ កន ុងការផ្តល់ព័ត្៌មានតាមទប្មង់ ខ្ែលអាចចូលបប្រើប្ាស់ាន ក៏អាចរកាន បដាយឥត្គិត្ថ្លៃផ្ងខ្ែរ។ បៅទូរសពទបៅ 704-940-4000 ឬនិយាយបៅកាន់អ្នកផ្តល់បសវាររស់អ្នក។”

German (Deutsch)

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlose Sprachassistenzdienste zur Verfügung. Entsprechende Hilfsmittel und Dienste zur Bereitstellung von Informationen in barrierefreien Formaten stehen ebenfalls kostenlos zur Verfügung. Rufen Sie 704-940-4000 an oder sprechen Sie mit Ihrem Provider.“

Hindi (ह िंदी)

ध्यान दें: यहद आप ह िंदी बोलते ैं, तो आपकेहलए हनिःशुल्क भाषा स ायता सेवाएिं उपलब्ध ोती ैं। सुलभ प्रारूपोिंमेंजानकारी प्रदान करनेकेहलए उपयुक्त स ायक साधन और सेवाएँभी हनिःशुल्क उपलब्ध ैं। 704-940-4000 पर कॉल करेंया अपनेप्रदाता सेबात करें ।”

Lao (ລາວ)

ເຊີ ນຊາບ: ຖ້າທ່ານເວ ້າພາສາ ລາວ, ຈະມີ ບໍ ລິ ການຊ່ວຍດ້ານພາສາແບບບໍ່ ເສຍຄ່າໃຫ້ທ່ານ. ມີ ເຄ ່ ອງຊ່ວຍ ແລະ ການບໍ ລິ ການແບບບໍ່ ເສຍຄ່າທີ່ ເໝາະສ ມເພ ່ ອໃຫ້ຂໍ້ມູນໃນຮູບແບບທີ່ ສາມາດເຂ ້າເຖິ ງໄດ້. ໂທຫາເບີ 704-940-4000 ຫ ລ ມກັ ບຜູ້ ໃຫ້ບໍ ລິ ການຂອງທ່ານ.”

Japanese (日本語)

注：日本語を話される場合、無料の言語支援サービスをご利用いただけます。ア クセシブル（誰もが利用できるよう配慮された）な形式で情報を提供するための 適切な補助支援やサービスも無料でご利用いただけます。704-940-4000 までお電話ください。または、ご利用の事業者にご相談く ださい。