Park Avenue Surgery complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The facility does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

The facility 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, accessible electronic formats, other formats)
• The facility provides free language services to people whose primary language is not English, such as qualified interpreters and Information written in other languages.

If you need these services, contact Shana Ackerman, Facility Director, at 212-433-0737.

LANGUAGE SERVICES

ENGLISH ATTENTION:

If you do not speak English, assistance is available to you free of charge. Please ask for assistance from a staff member.

ESPAÑOL SPANISH ATENCIÓN:

Si habla una de las lenguas, la asistencia está a su disposición de forma gratuita. Por favor, pedir ayuda a un miembro del personal.

If you believe the facility 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:

Shana Ackerman, Facility Director, at 212-433-0737.

Park Avenue Surgery
737 Park Avenue, Suite 1B
New York, NY 10021

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