Affordable Care Act – Nondiscrimination

Notice Informing Individuals About Nondiscrimination and Accessibility Requirements

Cypress Surgery Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

What We Provide

Free aid 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, other formats)
  • Free language services to people whose primary language is not English, such as:
  • Qualified interpreters
  • Information written in other languages

If you need these services, contact an employee who will assist you in obtaining the services.

If you believe that we have 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:

Compliance Officer

5016 W. Cypress St.
Ste. #100
Tampa, FL 33607
Phone: 813-542-2586
Fax: 813-392-1975
Email: jlewis@gastro-md.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the administrator or another 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, 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.