Notice of Nondiscrimination
Midwest Eye Care, PC and Midwest Eye Surgery Center, LLC (collectively, “Provider”) comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. Provider does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. 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 Calla Pappas. If you believe that Provider 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: Calla Pappas, HR and Compliance Manager, 4353 Dodge Street, Omaha, NE 68132, 402.552.2020 (phone), 402.552.2367 (fax) or answers@midwesteyecare.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Calla Pappas 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.
Español (Spanish)
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-402-552-2819.
Tiếng Việt (Vietnamese)
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-402-552-2819.
Statement regarding availability of language services
Español (Spanish)
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-402-552-2819.
Tiếng Việt (Vietnamese)
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-402-552-2819.
繁體中文 (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1-402-552-2819.
العربية (Arabic)
ال عرب ية .9182-255-204-1: مكبلاو مصلا فتاه مقر -ت تواف ر ل ك ب ال مجان. ات صل ب رق م 1م لحوظة: إذا ك نت ت تحدث اذك ر ال لغة، ف إن خدمات ال م ساعدة ال لغوي ة
Français (French)
ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-402-552-2819.
Oroomiffa (Oromo (to substitute for Cushite))
XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-402-552-2819.
Deutsch (German)
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-402-552-2819.
한국어 (Korean)
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-402-552-2819.번으로 전화해 주십시오.
नेपाली (Nepali)
ध्यान दिनहुोस: ्तपार्इंलेनेपाली बोल्नहुुन्छ भनेतपार्इंको ननम्तत भाषा सहायता सेवाहरू ननिःशल्ुक रूपमा उपलब्ध छ । फोन गनहुु ोस ्1-402-552-2819.
Русский (Russian)
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-402-552-2819.
ພາສາລາວ (Lao)
ໂປດຊາບ: ຖ້າວ່ າ ທ່ ານເ ວ້ າພາສາ ລາວ, ການໍບິລການຊ່ ວຍເຫຼື ອດ້ ານພາສາ, ໂດຍໍ ່ບເສັ ຽຄ່ າ, ແມ່ ນມີ ພ້ ອມໃຫ້ທ່ ານ. ໂທຣ 1-402-552-2819.
ک وردی (hsidruK)
ئ اگ اداری: ئ ھ گھر ب ھ زمان ی ک وردی ق ھ سھ دەک ھ یت، خزمھ ت گوزاري ھ کان ی ي ارمھ تی زمان، ب ھخۆڕاي ی، ب ۆ ت ۆ ب ھردە س تھ. .ھکب .TTY 1-402-552-2819.یدنەویھپ ھب ف ار سی
(israF) ب ھ
زب ان ف ار سی گ ف ت گو می ک ن ید، ت سھ یالت زب ان ی ب صورت راي گان ب رای شما ت وجھ: اگ ر .سامت دیریگب 1-402-552-2819.مھارف یم دشاب .اب
日本語 (Japanese)
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。1-402-552-2819.まで、お電話にてご連絡ください。
