St. Dominic Hospital

Winter 2017

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Discrimination is Against the Law St. Dominic Health Services (St. Dominic's) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. St. Dominic's does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. If you believe that St. Dominic's has failed to provide these services or discriminated in another way on the basis of race, color, national origin, K. Jerry Farr, Chair, Patient Grievance Committee 969 Lakeland Drive Jackson, MS 39216 601-200-5123 phone 601-200-0989 fax icare@stdom.com email available to help you. If you need these aids and services, contact a St. Dominic's staff member. ATTENTION: If you speak another language, language assistance services are available to you free of charge. Contact a St. Dominic's staff member for assistance. https://ocrportal.hhs.gov/ocr/smartscreen/main.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: St. Dominic's provides free aids and services to individuals who are blind or have hearing loss such as: • • Written information in non-standard formats St. Dominic's provides free language services to individuals whose primary language is not English such as: • • Written information in another language ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Habla con un empleado de St. Dominic's para recibir asistencia. Spanish Español

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