jOHEnglish

Copley Hospital complies with applicable Federal civil rights laws and does not discriminate, exclude or treat people differently on the basis of race, color, national origin, age, disability, or sex.

Copley Hospital:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:

o   Qualified sign language interpreters

o   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:

o   Qualified interpreters

o   Information written in other languages

If you need these services, please inform your nurse or PATIENT REGISTRATION.

If you believe that Copley Hospital 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: Copley Hospital’s Quality Management, 528 Washington Hwy, Morrisville, VT 05661, 802-888-8351.

You can file a grievance in person or by telephone, mail, or email. If you need help filing a grievance, Copley Hospital’s Corporate Compliance Officer is available to help you. Contact John Bond, Compliance Officer at 802-888-8897 or email jbond@chsi.org. For more information on filing a grievance visit: https://www.copleyvt.org/for-patients-and-visitors/hospital-complaint-process/

 

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
1-800-868-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Francais

Copley Hospital respecte les lois fédérales en vigueur relatives aux droits civiques et ne pratique aucune discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou un handicap. Copley Hospital n’exclut et ne traite aucune personne différemment en raison de sa race, sa couleur de peau, son origine nationale, son âge, son sexe ou son handicap. Copley Hospital :

  • Fournit gratuitement des aides et services aux personnes handicapées afin de permettre une communication efficace avec nous, par exemple :

○ Interprètes qualifiés en langue des signes

○ Informations écrites dans d’autres formats (gros caractères, audio, formats électroniques accessibles, autres formats)

  • Fournit gratuitement des services linguistiques aux personnes dont la langue principale n’est pas l’anglais, par exemple :

○ Interprètes qualifiés

○ Informations écrites dans d’autres langues

Si vous avez besoin de ces services, de l’hôpital Copley contactez Corporate Compliance Officer au 802-888-8350 ou 802-452-0619.

Si vous pensez que Copley Hospital n’a pas fourni ces services ou a fait preuve d’une autre forme de discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou le handicap, vous pouvez déposer une réclamation auprès de :Diane Dolan, Compliance Officer, Copley Hospital, 528 Washington Hwy., Morrisville, VT 05661, 802-888-8350, or via email at ddolan@chsi.org
Vous pouvez déposer une réclamation en personne ou par courrier, télécopie ou e-mail. Si vous avez besoin d’aide pour déposer une réclamation, Copley Hospital’s Corporate Compliance Officer] se tient à votre disposition pour vous y aider.

Vous pouvez également déposer une réclamation concernant vos droits civiques auprès de l’U.S. Département de la Santé et des Services Sociaux des États-Unis, Bureau des Droits Civiques, par voie électronique via l’Office for Civil Rights Complaint Portal, disponible à l’adresse https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, par courrier ou par téléphone à :

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)

Des formulaires de réclamation sont disponibles à l’adresse http://www.hhs.gov/ocr/office/file/index.html

Español

Copley Hospital cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Copley Hospital no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color, nacionalidad, edad, discapacidad o sexo. Copley Hospital:

  • Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que se comuniquen de manera eficaz con nosotros, como los siguientes:

○ Intérpretes de lenguaje de señas capacitados.

○ Información escrita en otros formatos (letra grande, audio, formatos electrónicos accesibles, otros formatos).

  • Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el inglés, como los siguientes:

○ Intérpretes capacitados.

○ Información escrita en otros idiomas.

Si necesita recibir estos servicios, comunicarse con el Oficial de Cumplimiento Corporativo de Copley hospital al 802-888-8350 o 802-452-0619.

Si considera que Copley Hospital no le proporcionó estos servicios o lo discriminó de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo, puede presentar un reclamo a la siguiente persona: Diane Dolan, Compliance Officer. Copley Hospital. 528 Washington Hwy., Morrisville, VT 05661. 802-888-8350, or via email at ddolan@chsi.org.
Puede presentar el reclamo en persona o por correo postal, fax o correo electrónico. Si necesita ayuda para hacerlo Copley Hospital’s Corporate Compliance Officer  está a su disposición para brindársela.

También puede presentar un reclamo de derechos civiles ante la Oficina de Derechos Civiles  del Departamento de Salud y Servicios Humanos,  de EE. UU. de manera electrónica a través de Office for Civil Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación:

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)

Puede obtener los formularios de reclamo en el sitio web http://www.hhs.gov/ocr/office/file/index.html.

中文

Copley Hospital  遵守適用的聯邦民權法律規定,不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人。Copley Hospital  不因種族、膚色、民族血統、年齡、殘障或性別而排斥任何人或以不同的方式對待他們。

Copley Hospital

  • 向殘障人士免費提供各種援助和服務,以幫助他們與我們進行有效溝通,如:

○ 合格的手語翻譯員

○ 以其他格式提供的書面資訊(大號字體、音訊、無障礙電子格式、其他格式)

  • 向母語非英語的人員免費提供各種語言服務,如:

○ 合格的翻譯員

○ 以其他語言書寫的資訊

如果您需要此類服務,請聯絡请联系Copley医院的公司合规官,电话:802-888-8350或802-452-0619。如果您認為 Copley Hospital 未能提供此類服務或者因種族、膚色、民族血統、年齡、殘障或性別而透過其他方式歧視您,您可以向 Diane Dolan  提交投訴,郵寄地址為 528 Washington Highway, Morrisville, VT 05661,電話號碼為802-888-8350, 電子信箱為ddolan@chsi.org。您可以親自提交投訴,或者以郵寄、傳真或電郵的方式提交投訴。如果您在提交投訴方面需要幫助,Copley医院的公司合规官 可以幫助您。

您還可以向 U.S. Department of Health and Human Services(美國衛生及公共服務部)的 Office for Civil Rights(民權辦公室)提交民權投訴,透過 Office for Civil Rights Complaint Portal 以電子方式投訴:https://ocrportal.hhs.gov/ocr/portal/lobby.jsf,或者透過郵寄或電話的方式投訴:

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)(聾人用電信設備)

登入 http://www.hhs.gov/ocr/office/file/index.html 可獲得投訴表格。

Tiếng Việt

Copley Hospital  tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính. Copley Hospital  không loại trừ mọi người hoặc đối xử với họ khác biệt vì chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính.

Copley Hospital:

  • Cung cấp dịch vụ hỗ trợ miễn phí cho những người khuyết tật để giao tiếp với chúng tôi có hiệu quả, như:

○ Thông dịch viên ngôn ngữ ký hiệu đủ năng lực

○ Thông tin bằng văn bản ở các định dạng khác (chữ in lớn, âm thanh, định dạng điện tử có thể tiếp cận, các định dạng khác)

  • Cung cấp miễn phí các dịch vụ ngôn ngữ cho những người có ngôn ngữ chính không phải là tiếng Anh, như:

○ Thông dịch viên đủ năng lực

○ Thông tin được trình bày bằng ngôn ngữ khác

Nếu bạn cần những dịch vụ này, hãy liên hệ liên hệ với công ty Compliance Officer tại 802-888-8350 hoặc 802-452-0619.
Nếu bạn tin rằng Copley Hospital  không cung cấp những dịch vụ này hoặc phân biệt đối xử theo cách khác dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính, bạn có thể nộp đơn khiếu nại với: Diane Dolan, Copley Hospital, 528 Washington Highway, Morrisville, VT 05661, 802-888-8350 or ddolan@chsi.org.

Bạn có thể trực tiếp nộp đơn khiếu nại hoặc gửi qua đường bưu điện, chuyển fax, hoặc email. Nếu bạn cần trợ giúp nộp đơn khiếu nại, Cán bộ tuân thủ của công tysẵn sàng giúp bạn.

Bạn cũng có thể nộp đơn khiếu nại về dân quyền lên U.S. Department of Health and Human Services (Bộ Y Tế và Dịch Vụ Nhân Sinh Hoa Kỳ), Office for Civil Rights (Văn Phòng Dân Quyền) bằng hình thức điện tử qua Office for Civil Rights Complaint Portal, có trên trang https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, hoặc qua đường bưu điện hoặc bằng điện thoại tại:

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)

Các mẫu khiếu nại có trên trang http://www.hhs.gov/ocr/office/file/index.html.

नेपाली

Copley Hospital  ले उपयुक्त संघीय अधिकारको व्यवस्थासँगै पालन गर्छ र वंश, रङ, राष्ट्रियता, उमेर, अपाङ्गता वा लिङ्गको आधारमा भेदभाव गर्दैन । Copley Hospital  ले वंश, रङ, राष्ट्रियता, उमेर, अपाङ्गता वा लिङ्गको कारण मानिसहरूलार्इ भिन्न रूपले व्यवहार वा मानिसहरूलार्इ बेवास्ता गर्दैन ।

Copley Hospital:

  • यसले हामीसँग प्रभावकारी रूपमा संचार गर्न अपाङ्गता भएका मानिसहरूलार्इ निःशुल्क सहायता र सेवाहरू प्रदान गर्छ, जस्तैः
    • योग्य साङ्केतिक भाषा अनुवाद गर्नेहरू
    • अन्य ढाँचाहरूमा लिखित जानकारी (ठूलो प्रिन्ट, अडियो, सजिलै पहुँच भएको इलेक्ट्रोनिक ढाँचाहरू, अन्य ढाँचाहरू)
  • प्राथमिक भाषा अङ्ग्रेजी नभएका मानिसहरूलार्इ निःशुल्क भाषाका सेवाहरू प्रदान गर्ने, जस्तैः
    • योग्य अनुवादकहरू
    • अन्य भाषाहरूमा लिखित जानकारी

तपार्इंलार्इ यी सेवाहरू आवश्यक छ भने तपाईं यी सेवाहरू आवश्यक छ भने, कृपया आफ्नो नर्स 802-888-8350 वा 802-452-0619 मा Copley अस्पताल गरेको अनुपालन अधिकारी जानकारी दिन वा सम्पर्कमा सम्पर्क गर्नुहोस्

Copley Hospital  ले यी सेवाहरू प्रदान गर्न असफल भएको छ अथवा वंश, रङ, राष्ट्रियता, उमेर, अपाङ्गता वा लिङ्गको आधारमा अन्य तरिकामा भेदभाव गरेको छ भनेर तपार्इंले विश्वास गर्नुहुन्छ भने तपार्इंले गुनासो गर्न सक्नुहुन्छः Diane Dolan, Corporate Compliance Officer, Copley Hospital, 528 Washington Highway, Morrisville, VT 05661, 802-888-8350, email at ddolan@chsi.org. । तपार्इंले पत्र,फ्याक्स वा इमेलबाट वा व्यक्तिगत रूपमा गुनासो गर्न सक्नुहुन्छ । गुनासो गर्न तपार्इंलार्इ सहायताको खाँचो छ भने Copley अस्पताल गरेको अनुपालन अधिकारीमा तपार्इंलार्इ सहायता उपलब्ध छ ।

तपार्इंले Office for Civil Rights (नागरिक अधिकारको कार्यालय), U.S. Department of Health and Human Services (यु.एस. स्वास्थ्य र मानव सेवा विभाग) सँग नागरिक अधिकारको गुनासो दर्ता पनि गर्न सक्नुहुन्छ, Office for Civil Rights Complaint Portal को निम्ति कार्यालयबाट इलेक्ट्रोनिक रूपमा https://ocrportal.hhs.gov/ocr/portal/lobby.jsf मा वा पत्र वा फोनबाट यहाँ उपलब्ध छः

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

1-800-868-1019, 800-537-7697 (टिडिडि)

गुनासो फाराम http://www.hhs.gov/ocr/office/file/index.html मा उपलब्ध छन् ।

Srpsko-hrvatski

Copley Hospital  pridržava se važećih saveznih zakona o građanskim pravima i ne pravi diskriminaciju po osnovu rase, boje kože, nacionalnog porijekla, godina starosti, invaliditeta ili pola.  [Name of covered entity] ne isključuje ljudi niti ih tretira drugačije zbog njihove rase, boje kože, nacionalnog porijekla, godina starosti, invaliditeta ili pola.

Copley Hospital:

  • Pruža besplatnu pomoć i usluge osobama sa invaliditetom kako bi komunicirali efikasno s nama, poput:

○ kvalifikovanih tumača za znakovni jezik

○ pisanih informacija u drugim formatima (veća slova štampanih materijala, audio format, dostupni elektronski i drugi formati)

  • Pruža besplatne jezičke usluge osobama čiji maternji jezik nije engleski, poput:

○ kvalifikovanih jezičkih tumača

○ informacija napisanih na drugim jezicima

Ako su vam potrebne ove usluge, kontaktirajte Ako trebate ove usluge, molimo obavijestite medicinsku sestru ili kontaktirajte Copley bolnici i usklađenost na 802-888-8350 ili 802-452-0619.

Ako mislite da vam Copley Hospital  nije pružio ove usluge ili ste bili izloženi diskriminaciji na neki drugi način po osnovu rase, boje kože, nacionalnog porijekla, godina starosti, invaliditeta ili pola, možete podnijeti prigovor sljedećoj ustanovi  Diane Dolan, Compliance Officer, Copley Hospital , 528 Washington Hwy, Morrisville, VT 05661, 802-888-8350, or via email at ddolan@chsi.org. Prigovor možete podnijeti lično, poštom, faksom ili elektronskom poštom. Ako vam je potrebna pomoć za podnošenje prigovora Copley bolnički Korporativna usklađenostje dostupan da vam pomogne.

Takođe možete podnijeti žalbu u vezi građanskih prava ministarstvu U.S. Department of Health and Human Services (Ministarstvo zdravlja i socijalnih usluga), Office for Civil Rights (Služba za građanska prava) elektronski preko Office for Civil Rights Complaint Portal, dostupnog na https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, ili poštom ili telefonom na:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

1-800-868-1019, 800-537-7697 (TDD – Telefon za osobe sa oštećenim govorom ili sluhom)

Obrasci žalbe dostupni su na http://www.hhs.gov/ocr/office/file/index.html.

Deutsche

Copley Hospital erfüllt geltenden bundesstaatliche Menschenrechtsgesetze und lehnt jegliche Diskriminierung aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab. Copley Hospital lehnt den Ausschluss oder die unterschiedliche Behandlung von Menschen aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab.

Copley Hospital:

  • Bietet kostenlose Hilfe und Dienstleistungen für Menschen mit Behinderung zur effektiven Kommunikation, wie z. B.:

○ Qualifizierte Gebärdensprachen-Dolmetscher

○ Schriftliche Informationen in anderen Formaten (große Ausdrucke, Audio, zugängliche elektronische Formate, sonstige Formate)

  • Bietet kostenlose Sprachdienste für Menschen, deren Hauptsprache nicht Englisch ist, wie z. B.:

○ Qualifizierte Dolmetscher

○ Schriftliche Informationen in anderen Sprachen

Sollten Sie diese Dienstleistungen benötigen, so wenden Sie sich an Wenn Sie diese Dienste benötigen, informieren Sie bitte Ihre Krankenschwester oder wenden Sie sich an den Compliance Officer von Copley Hospital unter 802-888-8350 oder 802-452-0619.
Sollten Sie der Ansicht sein, dass Copley Hospital  es versäumte, diese Dienstleistungen anzubieten, oder auf sonstige Weise aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht diskriminierte, so können Sie eine Beschwerde einreichen bei: Diane Dolan, Compliance Officer, Copley Hospital , 528 Washington Hwy, Morrisville, VT 05661, 802-888-8350, or via email at ddolan@chsi.org. Sie können eine Beschwerde persönlich oder per Post, Fax oder E-Mail einreichen. Sollten Sie Hilfe beim Einreichen einer Beschwerde benötigen, so steht Ihnen Copley Krankenhaus Corporate Compliance Officergerne zur Verfügung.

Sie können ebenfalls eine Menschenrechtsbeschwerde einreichen bei: Department of Health and Human Services (U.S.-Gesundheitsministerium), Office for Civil Rights (Amt für Bürgerrechte), elektronisch über das Office for Civil Rights Complaint Portal, zugänglich über https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, oder per Post oder telefonisch an:

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)

Beschwerdeformulare sind verfügbar unter http://www.hhs.gov/ocr/office/file/index.html

Cushite

Copley Hospital  seera hawwaasummaa Feederaalaan kan wal simu ta’ee sanyii, bifa, dhiigaan, uumriidhaan, yookiin koorniyaadhaan kan wal hin loognee dha.

Copley Hospital  namoota yookiin sanyii sanyiidhaan, bifaan, dhiigaan, umriidhaan, hir’ina qaamaan yookiin koorniyaadhaan adda hin baasu.

Copley Hospital:

  • Namootni hir’ina garaagaraa qaban bifa gaarii ta’een nu waliin haasa’uu akka danda’aniif deeggarsa fi tajaajila tolaa kennaafii, kanneen akka:

○ Namoota afaan mallattoo haalaan hiikkuu danda’an

○ Odeeffannoo barreeffamaa foormaatii adda ta’een (barreeffama guddaadhaan, sagaleedhaan, foormaatii eleektirooniksii argamuu danda’uun, foormaatii biroo)

  • Namoota afaan dhalootaa isaanii afaan Ingiliffaa hin taaneef tajaajila afaanii tolaa dhiheessuufi, kanneen akkaL:

○ Warra dandeettii afaan hiikuu gahaa ta’e qaban

○ Odeeffannoo afaanota birootiin barraahe

Tajaajila kana yoo barbaadde, Haddii aad u baahan tahay adeegyadan, fadlan u sheeg kalkaaliyahaaga ama la xiriir Sarkaalka Compliance Hospital Copley ee 802-888-8350 ama 802-452-0619 qunnamaa

Kana yoo itti amante Copley Hospital tajajila kana kennuudhaaf hin dandeenye yookiin tajaajila kana kennuu hin dandeenye yookiin sanyiidhaan ,bifaan, dhiigaan, umriidhaan, hiri’ina qaamaan, ykn koorniyaadhaanii fi kanneen birootiin looguu, komii keessan kanneen armaan gadiitiin dhiheessuu ni dandeessu: Diane Dolan, Corporate Compliance Officer, Copley Hospital, 528 Washington Highway, Morrisville, VT 05661. 802-888-8350, via email at ddolan@chsi.org. .Komii namaan, yookiin poostaadhaan, faaksiidhaan, yookiin e-mail dhaan dhiheessuu ni dandeessa. Komii guutuudhaaf gargaarsa yoo barbaadde, Haddii aad u baahan tahay adeegyadan, fadlan u sheeg kalkaaliyahaaga ama la xiriir Sarkaalka Compliance Corporate Hospital eesi gargarudhaaf qophii dha.

Komiiwwan mirga namoomaa U.S. Department of Health and Human Services (Kutaa Fayyaa fi Tajaajila Namoomaa U.S), Office for Civil Rights (Waajjira Mirga Hawwaasummaa)  eleektirooniksiidhaan the Office for Civil Rights Complaint Portal, kunis kan argamu https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, ykn  poostaadhaan yookiin bilbilaan :

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

1-800-868-1019, 800-537-7697 (TDD)

Foormiin komiidhaa kan argamu http://www.hhs.gov/ocr/office/file/index.html irratti dha.

Italiano

Copley Hospital è conforme a tutte le leggi federali vigenti in materia di diritti civili e non pone in essere discriminazioni sulla base di razza, colore, origine nazionale, età, disabilità o sesso. Copley Hospital non esclude le persone o le tratta diversamente a causa di razza, colore, origine nazionale, età, disabilità o sesso.

Copley Hospital:

  • Offre sostegni e servizi gratuiti alle persone affette da disabilità per comunicare con noi in modo efficace, quali:

○ Interpreti qualificati nella lingua dei segni

○ Informazioni scritte in altri formati (stampe a grandi caratteri, audio, formati elettronici accessibili, altri formati)

  • Offre servizi linguistici gratuiti alle persone la cui lingua primaria non è l’inglese, quali:

○ Interpreti qualificati

○ Informazioni scritte in altre lingue

In caso si necessiti di tali servizi, contattare Se avete bisogno di questi servizi, si prega di informare l’infermiere o contattare il Compliance Officer di Copley Hospital a 802-888-8350 o 802-452-0619. In caso si ritenga che Copley Hospital  non abbia offerto tali servizi o abbia posto in essere discriminazioni in altri modi sulla base di razza, colore, origine nazionale, età, disabilità o sesso, è possibile presentare una vertenza a: Diane Dolan, Corporate Compliance Officer, Copley Hospital, 528 Washington Highway, Morrisville, VT 05661. 802-888-8350, via email at ddolan@chsi.org. È possibile presentare una vertenza di persona o a mezzo posta, fax oppure e-mail. In caso si necessiti di aiuto per la presentazione della vertenza Compliance Officer di Copley Hospital è disponibile a fornire assistenza.

È altresì possibile presentare un reclamo per i diritti civili allo U.S. Department of Health and Human Services (Dipartimento statunitense per la salute e i servizi umani), Office for Civil Rights (Ufficio per i diritti civili), elettronicamente mediante il Office for Civil Rights Complaint Portal, disponibile all’indirizzo https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, oppure a mezzo posta o telefono all’attenzione di:

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)

I moduli di reclamo sono disponibili all’indirizzo http://www.hhs.gov/ocr/office/file/index.html.

العربية

يلتزمCopley Hospital بقوانين الحقوق المدنية الفدرالية المعمول بها ولا يميز على أساس العرق أو اللون أو الأصل الوطني أو السن أو الإعاقة أو نوع الجنس. لا يستبعد [Copley Hospital  الأشخاص أو يعاملهم على نحو مختلف بسبب النوع أو اللون أو الأصل الوطني أو السن أو الإعاقة أو نوع الجنس.

[Copley Hospital :

  • يوفر مساعدات وخدمات مجانية للأشخاص من ذوي الإعاقات للتواصل بصورة فعالة معنا، مثل:

○ مترجمي لغة إشارة مؤهلين

○ معلومات كتابية بتنسيقات أخرى (مطبوعة بأحرف كبيرة، مواد صوتية، تنسيقات إلكترونية متيسرة، وغير ذلك من التنسيقات)

  • يوفر خدمات لغوية مجانية للأشخاص الذين لغتهم الأساسية ليست الإنجليزية، مثل:

○ مترجمين مؤهلين

○ معلومات مكتوبة بلغات أخرى

إذا كنت بحاجة لهذه الخدمات، اتصل بـ r إذا كنت بحاجة إلى هذه الخدمات، يرجى إبلاغ الممرضة أو اتصل ضابط الامتثال مستشفى كوبلي وفي 802-888-8350 أو 802-452-0619]

إذا كنت تعتقد أن [Copley Hospital  قد أخفق في توفير تلك الخدمات أو ميز بطريقة أخرى على أساس العرق أو اللون أو الأصل الوطني أو السن أو الإعاقة أو الجنس، يمكن أن تتقدم بشكوى إلى: [Diane Dolan, Copley Hospital’s Corporate Compliance Officer 802-888-8350 or email ddolan@chsi.org, 528 Washington Highway Morrisville, VT 05661 يمكن أن تتقدم بشكوى شخصيًا أو بالبريد أو بالفاكس أو البريد الإلكتروني. إذا كنت بحاجة للمساعدة في التقدم بشكوى، ] متاح لمساعدتك.

يمكن أيضًا أن تتقدم بشكوى إلكترونيًا لوزارة Department of Health and Human Services (وزارة الخدمات الصحية والبشرية) ، مكتب Office for Civil Rights (مكتب الحقوق المدنية)،  من خلال مكتب Office for Civil Rights Complaint Portal، المتوفر على الرابط  https://ocrportal.hhs.gov/ocr/portal/lobby.jsf أو بالبريد أو الهاتف على:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

1-800-863-1019, 800-537-7697 (رقم هاتف الصم والبكم)

تتوافر نماذج الشكاوى على الرابط http://www.hhs.gov/ocr/office/file/index.html.

Русский

Copley Hospital  соблюдает применимое федеральное законодательство в области гражданских прав и не допускает дискриминации по признакам расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола.  Copley Hospital не исключает людей и не относится к ним по-разному из-за расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола.

Copley Hospital

  • Для эффективного взаимодействия предоставляет безвозмездную помощь и оказывает услуги людям с ограниченными возможностями, а именно:

○ услуги квалифицированных сурдопереводчиков;

○ письменную информацию в других форматах (крупный шрифт, аудио формат, доступные электронные форматы, прочие форматы).

  • Предоставляет бесплатные услуги перевода людям, для которых английский не является основным языком, а именно:

○ услуги квалифицированных переводчиков;

○ письменную информацию на других языках.

Если вы нуждаетесь в таких услугах, обратитесь к Если вам нужны эти услуги, пожалуйста, сообщите об этом медсестре или связаться с Комплаенс Копли больницы на 802-888-8350 или 802-452-0619
Если вы считаете, что в Copley Hospital  вам не предоставили указанных услуг или иным образом дискриминировали вас по признакам расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола, вы можете подать жалобу Diane Dolan, Copley Hospital Corporate Compliance Officer, 528 Washington Highway, Morrisville, VT 05661,  802-888-8350, by email ddolan@chsi.org.  Вы можете подать жалобу лично или отправить по почте, факсу или электронной почте. Если вам нужна помощь в подаче жалобы, вам поможет  Сотрудник по корпоративному соблюдению Копли Больницы

Вы также можете подать жалобу о нарушении гражданских прав в U.S. Department of Health and Human Services (Министерство здравоохранения и социальных служб США), Office for Civil Rights (Управление по гражданским правам), в электронном виде через Office for Civil Rights Complaint Portal, доступный по ссылке: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, по почте или по телефону:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201 (США)

1-800-368-1019, 800-537-7697 (TDD)

Бланки жалобы доступны по адресу: http://www.hhs.gov/ocr/office/file/index.html.

Tagalog

Sumusunod ang Copley Hospital sa mga naaangkop na Pampederal na batas sa karapatang sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.  Ang [Name of covered entity] ay hindi nagtatangi ng mga tao o hindi nagpapakita ng ibang pakikitungo dahil sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.

Ang Copley Hospital ay:

  • Nagbibigay ng mga libreng tulong at serbisyo sa mga taong may kapansanan upang mahusay silang makipag-ugnayan sa amin, gaya ng:

○ Mga kwalipikadong interpreter ng sign language

○ Nakasulat na impormasyon sa iba pang mga format (malaking print, audio, mga naa-access na electronic na format, iba pang mga format)

  • Nagbibigay ng mga libreng serbisyo sa wika sa mga taong hindi Ingles ang pangunahing wika, gaya ng:

○ Mga kwalipikadong interpreter

○ Impormasyong nakasulat sa iba pang mga wika

Kung kailangan mo ang mga serbisyong ito, makipag-ugnayan kay Kung kailangan mo ng mga serbisyong ito, mangyaring ipaalam sa iyong nars o makipag-ugnayan sa Copley Hospital Compliance Officer sa 802-888-8350 o 802-452-0619
Kung naniniwala kang hindi naibigay ng Copley Hospital ang mga serbisyong ito o nandiskrimina ito sa ibang paraan batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian, maaari kang maghain ng karaingan sa: Diane Dolan, Copley Hospital Corporate Compliance Officer, 518 Washington Highway, Morrisville, VT 05661, 802-888-8350, or email ddolan@chsi.org. Maaari kang maghain ng karaingan nang personal o sa pamamagitan ng koreo, fax o email. Kung kailangan mo ng tulong sa paghahain ng karaingan, narito si Corporate Compliance Officer Copley Hospitalupang tulungan ka.

Maaari ka ring maghain ng reklamo sa mga karapatang sibil sa U.S. Department of Health and Human Services (Kagawaran ng Mga Serbisyong Pangkalusugan at Pantao ng U.S.), Office for Civil Rights (Tanggapan para sa Mga Karapatang Sibil), sa electronic na paraan sa Office for Civil Rights Complaint Portal, na makikita sa https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o sa pamamagitan ng koreo o telepono sa:

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)

Ang mga form ng reklamo ay makukuha sa http://www.hhs.gov/ocr/office/file/index.html.

Português

Copley Hospital cumpre as leis de direitos civis federais aplicáveis e não exerce discriminação com base na raça, cor, nacionalidade, idade, deficiência ou sexo.  Copley Hospital não exclui ou trata de forma diferente devido à raça, cor, nacionalidade, idade, deficiência ou sexo.

Copley Hospital:

  • Faculta ajuda e serviços gratuitos a pessoas com dificuldades de comunicar de forma eficaz connosco, tais como:

○ Intérpretes de língua gestual qualificados

○ Informação escrita noutros formatos (impressão maior, áudio, formatos electrónicos acessíveis, outros formatos)

  • Faculta serviços linguísticas grátis a pessoas cuja língua principal não é inglês, tais como:

○ Intérpretes qualificados

○ Informação escrita noutros idiomas

Se necessita destes serviços, contacte Se você precisar desses serviços, por favor informe o seu enfermeiro ou entre em contato com Compliance Officer da Copley Hospital em 802-888-8350 ou 802-452-0619

Se considera que a Copley Hospital não cumpriu estes serviços ou exerceu discriminação de outra forma com base na raça, cor, nacionalidade, idade, deficiência ou sexo, pode apresentar uma reclamação junto de: Diane Dolan, Copley Hospital Corporate Compliance Officer, 528 Washington Highway, Morrisville, VT 05661, 802-888-8350, or email ddolan@chsi.org. Pode apresentar uma reclamação pessoalmente ou por correio, fax ou e-mail. Se precisar de ajuda para efectuar a reclamação, o/a Compliance Officer Corporativa da Copley Hospital estará disponível para o/a auxiliar.

Pode também apresentar uma reclamação de direitos civis junto do U.S. Department of Health and Human Services (Departamento de Saúde e dos Serviços Humanos dos Estados Unidos da América), Office for Civil Rights (Gabinete de Direitos Civis), por via electrónica através do Office for Civil Rights Complaint Portal, disponível em https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, ou por correio ou telefone:

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)

Os formulários de reclamações encontram-se disponíveis em http://www.hhs.gov/ocr/office/file/index.html.

日本語

Copley Hospital は適用される連邦公民権法を遵守し、人種、肌の色、出身国、年齢、障害、または性別に基づく差別をいたしません。Copley Hospital は人種、肌の色、出身国、年齢、障害、または性別を理由として人を排除したり、異なる扱いをいたしません。

Copley Hospital:

  • 効果的にコミュニケーションを図るため、障害のある人に以下の支援やサポートを無料で提供いたします。

○ 資格ある手話通訳者

○ その他形式の文字情報(大きな活字、音声信号、手軽な電子形式、その他)

  • 英語を母語としない人へ以下の言語サービスを無料で提供いたします。

○ 資格ある通訳者

○ 英語以外の言語で書かれた情報

これらのサービスを必要とされる場合は、あなたはこれらのサービスが必要な場合は、802-888-8350または802-452-0619でコプリー病院のコンプライアンスオフィサーをあなたの看護師をお知らせやお問い合わせください]までご連絡ください。

Copley Hospital がこれらのサービスの提供を怠ったり、人種、肌の色、出身国、年齢、障害、または性別に基づいた何らかの方法で差別したと思われる場合、こちらまで苦情を申し立てることができます:Diane Dolan, Copley Hospital’s Corporate Compliance Officer, 528 Washington Highway, Morrisville, VT 05661, 802-888-8320, via email ddolan@chsi.org。苦情の申し立ては、直接、または郵便、ファックス、メールで行うことができます。苦情を申し立てるにあたり援助が必要な場合は、コプリー病院のコンプライアンスオフィサー がお手伝いいたします。

また、公民権に関する苦情は、U.S. Department of Health and Human Services(保健社会福祉省)のOffice for Civil Rights(公民権局)へ、Office for Civil Rights Complaint Portal https://ocrportal.hhs.gov/ocr/portal/lobby.jsfから電子申請するか、以下へ郵便または電話で申し立てることもできます:

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)

苦情申立書はhttp://www.hhs.gov/ocr/office/file/index.htmlよりダウンロードいただけます。

ไทย

Copley Hospital ได้ปฏิบัติตามรัฐบัญญัติด้านสิทธิ์ที่เหมาะสม และไม่ได้มีการแบ่งแยกทางชาติพันธุ์ สีผิว เชื้อชาติ อายุ ความทุพพลภาพ หรือเพศ  \Copley Hospital ไม่ได้กีดกันผู้คน หรือเลือกปฏิบัติตามชาติพันธุ์ สีผิว เชื้อชาติ อายุ       ความทุพพลภาพ หรือเพศ

Copley Hospital:

  • นำเสนอความช่วยเหลือและบริการฟรีแก่ผู้มีความบกพร่องด้านการสื่อสารกับเรา เช่น:

○ ล่ามภาษามือที่ผ่านการรับรอง

○ ข้อมูลที่เป็นลายลักษณ์อักษรในรูปแบบอื่น (การพิมพ์ตัวใหญ่ เสียง รูปแบบอิเล็กทรอนิกส์ที่เข้าถึงได้ รูปแบบอื่นๆ)

  • ให้บริการด้านภาษาฟรีแก่บุคคลที่ไม่ได้มีภาษาอังกฤษเป็นภาษาแรก เช่น:

○ ล่ามที่ได้รับการรับรอง

○ ข้อมูลที่เขียนเป็นภาษาอื่น

ถ้าคุณต้องการบริการเหล่านี้ โปรดติดต่อ \[หากคุณต้องการบริการเหล่านี้โปรดแจ้งให้พยาบาลหรือติดต่อโรงพยาบาลเพลย์เจ้าหน้าที่ปฏิบัติตามกฎระเบียบที่ 802-888-8350 หรือ 802-452-0619

ถ้าคุณเชื่อว่า \Copley Hospital ไม่สามารถให้บริการเหล่านี้ได้ หรือมีความประพฤติแบ่งแยกในทางใดทางหนึ่ง เช่น ชาติพันธุ์ สีผิว เชื้อชาติ อายุ ความทุพพลภาพ หรือเพศ คุณสามารถร้องทุกข์ต่อ: \Diane Dolan, Copley Hospital Corporate Compliance Officer \528 Washington Highway, Morrisville, VT 05661 \802-888-8350 \ddolan@chsi.org.  คุณสามารถร้องทุกข์ด้วยตนเอง หรือทางไปรษณีย์ แฟกซ์ หรืออีเมล ถ้าคุณต้องการความช่วยเหลือในการร้องทุกช์ \[ โรงพยาบาลเพลย์เจ้าหน้าที่ปฏิบัติตามกฎระเบียบพร้อมจะช่วยคุณ

คุณยังสามารถร้องทุกข์สิทธิพลเมืองได้ต่อ U.S. Department of Health and Human Services (กระทรวงบริการด้านสุขภาพและมนุษย์แห่งสหรัฐอเมริกา) Office for Civil Rights (สำนักงานสิทธิพลเมือง) ได้ทางอิเล็กทรอนิกส์ผ่านช่องทาง Office for Civil Rights Complaint Portal https://ocrportal.hhs.gov/ocr/portal/lobby.jsf{3]{4], หรือทางไปรษณีย์หรือโทร:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

1-800-868-1019, 800-537-7697 (TDD)

รับแบบฟอร์มร้องทุกข์ที่ http://www.hhs.gov/ocr/office/file/index.html.