Nondiscrimination Statement:
Discrimination is Against the Law
Appendix A to Part 92 Notice Informing Accessibility Requirements
Zuleika M. Ghodsi, MD, PC dba. Delmarva Laser Eye Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Zuleika M. Ghodsi, MD, PC dba. Delmarva Laser Eye Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Zuleika M. Ghodsi, MD, PC dba. Delmarva Laser Eye Center:
Provides aids and services to people with disabilities to communicate effectively with us, such as:
· Qualified sign language interpreters (upon request)
· Written information in other formats (large print, audio, accessible electronic formats, other formats)
· Provides language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages (upon request)
If you need these services, contact Cindy Allen, Office Administrator. If you believe that Zuleika M. Ghodsi, MD, PC dba. Delmarva Laser Eye Center 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:
Cindy Allen, Office Administrator
405 Marvel Court
Easton, MD 21601
(410)822-9801
(410)822-9805 (Fax)
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
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-xxx-xxx-xxxx (TTY: 1-410-822-9801). Español (Spanish)
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ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le (TTY: 1-410-822-9801) Français (French)
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ียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร (TTY: 1-410-822-9801). ภาษาไทย (Thai)
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