OCR NOTICE OF NONDISCRIMINATION

Source: HHS Office for Civil Rights

Allisonville Outpatient Surgery Center, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Allisonville Outpatient Surgery Center, LLC
does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Allisonville Outpatient Surgery Center, LLC

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)
- 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 Rachelle Killion.

If you believe that Allisonville Outpatient Surgery Center, LLC
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:

Rachelle Killion Operations Manager
10967 Allisonville Rd. Suite 100
Fishers, IN 46038

Phone: (317) 569-0033 TTY: 200402610a
Fax: (317) 569-0540
Email: AOSCfishers@gmail.com can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Rachelle Killion, Operations Manager 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

Toll Free: 1-800-368-1019, 800-537-7697 (TDD).

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