Non-Discrimination Notice
Last updated: [date]
[LLC Legal Name] complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex in the home care services we provide.
Free help is available
- Free aids and services for people with disabilities to communicate effectively with us, such as qualified sign language interpreters and written information in other formats.
- Free language services for people whose primary language isn't English, such as qualified interpreters and information written in other languages.
If you need these services, contact [nondiscrimination coordinator contact].
How to file a grievance
If you believe [LLC Legal Name] has failed to provide these services or discriminated in another way, you can file a grievance with [nondiscrimination coordinator contact], or with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the OCR Complaint Portal at ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail.
Language assistance taglines
- ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al [phone number].
- CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số [phone number].
- 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 [phone number]。
- ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните [phone number].
- ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم [phone number].
Confirm this list against HHS OCR’s current top-15 language list for Colorado before publishing.