ACA Section 1557 Information
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Associates in Family Medicine, P.C. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Associates in Family Medicine, P.C. does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Associates in Family Medicine, P.C. provides free aids and services to people with disabilities to communicate effectively with us, such as:

Qualified sign language interpreters
Written information in accessible electronic formats
Associates in Family Medicine, P.C. also provides free language services to people whose primary language is not English, such as:

CyraCom Language Solutions interpretation
Information written in other languages
Other qualified interpreters
If you need these services, please contact Kris Jones at 970.495.6360.

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If you believe that Associates in Family Medicine, P.C. 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 in person or by fax with:

Civil Rights Coordinator

Associates in Family Medicine, P.C.

3702 Automation Way, Suite 103

Fort Collins, CO 80525

Fax: 970.495.6218.

If you need help filing a grievance, the Civil Rights Coordinator 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, 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

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Spanish:

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 970.495.6360.

Vietnamese:

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 970.495.6360.

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 970.495.6360.

Korean:

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 970.495.6360.

Russian:

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните

970.495.6360.

Amharic:

ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ

970.495.6360.

Arabic:

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 970.495.6360.

German:

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 970.495.6360.

French:

ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez

970.495.6360.

Nepali:

ध्यान दिनुहोस्: तपार्इंले नेपाली बोल्नुहुन्छ भने तपार्इंको निम्ति भाषा सहायता सेवाहरू निःशुल्क रूपमा उपलब्ध छ । फोन गर्नुहोस् 970.495.6360.

Tagalog:

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 970.495.6360.

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。970.495.6360.

Cushite:

Xiyyeeffannaa: osoo ati dubbachuu oromiffaa, afaan gargaarsa tajaajiluu miti kafalli hunduma argamaa gama ati. Yaamuu

970.495.6360.

Persian/Farsi:

توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 1- 970-495-6360. تماس بگیرید.

Yoruba:

Akiyesi: Ti o ba sọ Yorùbá, èdè iranlowo iṣẹ, free ti idiyele, ni o wa wa si o. 970.495.6360.