Nondiscrimination-Notice
Magnolia Surgery Center:
- Provides free auxiliary aids and services to people with disabilities to communicate effectively with us, such as:
- qualified sign language interpreters, video remote interpreting or other aids for hearing impaired individuals
- written information in multiple formats including large print, audio, accessible electronic formats, or other formats for visually impaired individuals
- Provides free language services to people whose primary language is not English, such as:
- qualified interpreters or a language line
- information written in other languages
If you need these services, contact Magnolia Surgery Center’s ADA Coordinator at 714-903-9039.
If you believe that Magnolia Surgery 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:
ADA Coordinator
Magnolia Surgery Center
14571 Magnolia Street Suite 107 Westminster, California 92683
Phone: 714-903-9039
Fax: 714-903-9439
rblanch@uspi.com
You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, Magnolia Surgery Center’s ADA 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