Shore Outpatient Surgicenter Nondiscrimination Notice

Shore Outpatient Surgicenter complies with applicable Federal civil rights laws and does not discriminate on the basis of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation and gender identity or expression.  Shore Outpatient Surgicenter does not exclude people or treat them differently because of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation and gender identity or expression.  Our health plans are also subject to the section 1557 nondiscrimination requirements and will be operated accordingly.

Shore Outpatient Surgicenter:

  • Provides free auxiliary aids and services to people with disabilities to communicate effectively with us, such as:
    • qualified sign language interpreters, video remote interpreting or other aids for hearing impaired individuals
    • written information in multiple formats including large print, audio, accessible electronic formats, or other formats for visually impaired individuals
  • Provides free language services to people whose primary language is not English, such as:
    • qualified interpreters or a language line
    • information written in other languages

If you need these services, contact Shore Outpatient Surgicenter’s ADA Coordinator at (732) 942-9835.

If you believe that Shore Outpatient Surgicenter 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:

ADA Coordinator
Shore Outpatient Surgicenter
360 Route 70
Lakewood, New Jersey 08701
Phone: (732) 942-9835
Fax: (732) 886-1573
claffont@upsi.com

You can file a grievance in person or by mail, fax or email.  If you need help filing a grievance, Shore Outpatient Surgicenter’s 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, 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

English ATTENTION:  If you speak another language, language assistance services, free of charge, are available to you.  Call 1-732-942-9835.
Spanish ATENCIÓN:  si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.  Llame al 1-732-942-9835.
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1-732-942-9835.
Korean 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-732-942-9835.번으로 전화해 주십시오.
Portuguese ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-732-942-9835.
Gujarati સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો  1-732-942-9835.
Polish UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-732-942-9835.
Italian ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-732-942-9835.
Arabic ملحوظة:  إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان.  اتصل برقم 1-732-942-3895 (رقم هاتف الصم والبكم:.
Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-732-942-9835.
Russian ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-732-942-9835.
French Creole ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-732-942-9835.
Hindi ध्यान दें:  यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं। 1-732-942-9835.) पर कॉल करें।
Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-732-942-9835..
French ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-732-942-9835.
Urdu خبردار: اگر آپ اردو بولتے ہیں، تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں ۔ کال کریں  (1-732-942-3895)

 

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